- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.79 / $1,885.00 / $3,693.00
| Facility | | $528.79 | $1,885.00 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.04 / $511.65 / $933.57
| Professional | | $335.04 | $511.65 | $933.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.18 / $2,854.00 / $9,039.00
| Facility | | $859.18 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.79 / $863.94 / $3,836.16
| Professional | | $405.79 | $863.94 | $3,836.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.79 / $562.55 / $1,004.29
| Facility | | $437.79 | $562.55 | $1,004.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.90 / $837.16 / $1,334.26
| Professional | | $598.90 | $837.16 | $1,334.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.99 / $766.61 / $1,441.81
| Professional | | $448.99 | $766.61 | $1,441.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.42 / $798.26 / $6,679.00
| Facility | | $369.42 | $798.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $613.73 / $746.84 / $1,030.94
| Professional | | $613.73 | $746.84 | $1,030.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.54 / $1,003.74 / $1,516.97
| Professional | | $479.54 | $1,003.74 | $1,516.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,050.05 / $3,050.05 / $3,050.05
| Facility | | $3,050.05 | $3,050.05 | $3,050.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.79 / $282.99 / $549.48
| Professional | | $224.79 | $282.99 | $549.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,871.79 / $3,764.00 / $16,394.00
| Facility | | $1,871.79 | $3,764.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $547.35 / $1,117.67 / $3,836.16
| Professional | | $547.35 | $1,117.67 | $3,836.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $4,366.46 / $9,821.00
| Facility | | $1,902.00 | $4,366.46 | $9,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.69 / $820.06 / $1,588.70
| Professional | | $487.69 | $820.06 | $1,588.70 |