- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.85 / $1,338.00 / $10,768.00
| Facility | | $518.85 | $1,338.00 | $10,768.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.85 / $547.42 / $971.51
| Professional | | $518.85 | $547.42 | $971.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,297.06 / $2,297.06 / $2,330.58
| Facility | | $2,297.06 | $2,297.06 | $2,330.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $612.33 / $1,109.14 / $2,309.17
| Professional | | $612.33 | $1,109.14 | $2,309.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.41 / $766.38 / $1,301.90
| Professional | | $578.41 | $766.38 | $1,301.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.85 / $676.59 / $1,035.93
| Facility | | $518.85 | $676.59 | $1,035.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.00 / $657.00 / $694.00
| Professional | | $579.00 | $657.00 | $694.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $707.60 / $1,374.10
| Professional | | $5.00 | $707.60 | $1,374.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.58 / $621.75 / $1,407.38
| Professional | | $453.58 | $621.75 | $1,407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,010.80 / $8,957.00 / $26,542.00
| Facility | | $3,010.80 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,881.76 / $3,881.76 / $4,622.55
| Professional | | $3,881.76 | $3,881.76 | $4,622.55 |