- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.41 / $687.92 / $7,278.00
| Facility | | $286.41 | $687.92 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.41 / $410.67 / $601.75
| Professional | | $286.41 | $410.67 | $601.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.91 / $154.91 / $154.91
| Professional | | $154.91 | $154.91 | $154.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.14 / $584.69 / $1,055.65
| Professional | | $210.14 | $584.69 | $1,055.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.09 / $515.53 / $954.47
| Professional | | $352.09 | $515.53 | $954.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.22 / $518.26 / $759.33
| Facility | | $294.22 | $518.26 | $759.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $569.00 / $600.00
| Professional | | $507.00 | $569.00 | $600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $580.10 / $1,186.00
| Professional | | $3.00 | $580.10 | $1,186.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.16 / $522.64 / $1,146.85
| Professional | | $376.16 | $522.64 | $1,146.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,369.28 / $1,508.22 / $16,394.00
| Facility | | $1,369.28 | $1,508.22 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,182.16 / $3,191.44 / $3,685.65
| Professional | | $2,182.16 | $3,191.44 | $3,685.65 |