- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,244.00 / $5,091.00 / $9,539.00
| Facility | | $1,244.00 | $5,091.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $683.88 / $791.83 / $1,211.49
| Professional | | $683.88 | $791.83 | $1,211.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,823.00 / $12,004.00 / $15,528.00
| Facility | | $9,823.00 | $12,004.00 | $15,528.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $704.39 / $900.76 / $1,489.22
| Professional | | $704.39 | $900.76 | $1,489.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $820.96 / $859.94 / $5,113.00
| Professional | | $820.96 | $859.94 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $860.40
| Facility | | $640.00 | $640.00 | $860.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $744.27 / $939.43 / $1,645.84
| Professional | | $744.27 | $939.43 | $1,645.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $726.64 / $930.42 / $1,099.58
| Professional | | $726.64 | $930.42 | $1,099.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.21 / $990.98 / $1,482.38
| Facility | | $776.21 | $990.98 | $1,482.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $922.00 / $1,054.00 / $1,462.00
| Professional | | $922.00 | $1,054.00 | $1,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $728.72 / $948.22 / $3,270.85
| Facility | | $728.72 | $948.22 | $3,270.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $728.72 / $948.22 / $3,270.85
| Professional | | $728.72 | $948.22 | $3,270.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $9,270.00 / $17,192.00
| Facility | | $5,121.00 | $9,270.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.98 / $915.01 / $1,425.06
| Professional | | $578.98 | $915.01 | $1,425.06 |