- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $3,090.30 / $8,317.64
| Facility | | $537.03 | $3,090.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $363.08 / $1,202.26
| Professional | | $138.04 | $363.08 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $138.04 / $489.78
| Professional | | $112.20 | $138.04 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $831.76 / $1,230.27
| Professional | | $537.03 | $831.76 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $363.08 / $1,318.26
| Professional | | $169.82 | $363.08 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $1,000.00 / $1,096.48
| Professional | | $776.25 | $1,000.00 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $933.25 / $1,348.96
| Professional | | $181.97 | $933.25 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $6,309.57 / $10,000.00
| Facility | | $3,548.13 | $6,309.57 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,691.53 / $8,317.64
| Facility | | $588.84 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $501.19 / $1,513.56
| Professional | | $147.91 | $501.19 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $1,479.11
| Facility | | $346.74 | $346.74 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $1,047.13 / $1,862.09
| Professional | | $331.13 | $1,047.13 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $645.65 / $831.76
| Facility | | $144.54 | $645.65 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $630.96 / $691.83
| Professional | | $144.54 | $630.96 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,238.72 / $5,011.87
| Facility | | $501.19 | $2,238.72 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $436.52 / $1,230.27
| Professional | | $144.54 | $436.52 | $1,230.27 |