- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.00 / $3,745.00 / $8,017.00
| Facility | | $760.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.48 / $480.18 / $636.69
| Professional | | $422.48 | $480.18 | $636.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.55 / $489.35 / $489.35
| Professional | | $471.55 | $489.35 | $489.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.77 / $631.52 / $1,025.76
| Professional | | $469.77 | $631.52 | $1,025.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.90 / $758.46 / $758.46
| Professional | | $565.90 | $758.46 | $758.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,017.00
| Facility | | $832.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.41 / $505.31 / $2,439.10
| Professional | | $442.41 | $505.31 | $2,439.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $702.20 / $1,168.70
| Professional | | $11.00 | $702.20 | $1,168.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.97 / $657.72 / $1,095.76
| Professional | | $487.97 | $657.72 | $1,095.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.89 / $461.89 / $560.21
| Facility | | $461.89 | $461.89 | $560.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.23 / $470.81 / $560.21
| Professional | | $441.23 | $470.81 | $560.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.33 / $573.76 / $968.64
| Professional | | $440.33 | $573.76 | $968.64 |