- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.52 / $2,671.00 / $4,806.64
| Facility | | $478.52 | $2,671.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.95 / $459.64 / $849.87
| Professional | | $312.95 | $459.64 | $849.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $795.15 / $2,854.00 / $9,039.00
| Facility | | $795.15 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.25 / $811.58 / $3,521.60
| Professional | | $373.25 | $811.58 | $3,521.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.39 / $517.07 / $923.08
| Facility | | $402.39 | $517.07 | $923.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $552.08 / $796.17 / $1,276.50
| Professional | | $552.08 | $796.17 | $1,276.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.12 / $710.04 / $1,365.83
| Professional | | $420.12 | $710.04 | $1,365.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $513.60 / $6,679.00
| Facility | | $214.32 | $513.60 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $561.22 / $682.00 / $941.42
| Professional | | $561.22 | $682.00 | $941.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.40 / $921.82 / $1,394.78
| Professional | | $440.40 | $921.82 | $1,394.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,221.46 / $2,221.46 / $6,691.03
| Facility | | $2,221.46 | $2,221.46 | $6,691.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.94 / $347.95 / $411.25
| Professional | | $192.94 | $347.95 | $411.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,724.73 / $3,764.00 / $26,542.00
| Facility | | $1,724.73 | $3,764.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.24 / $1,024.74 / $3,521.60
| Professional | | $510.24 | $1,024.74 | $3,521.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.11 / $751.41 / $1,503.15
| Professional | | $478.11 | $751.41 | $1,503.15 |