- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $684.77 / $6,500.00 / $30,714.25
| Facility | | $684.77 | $6,500.00 | $30,714.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.23 / $583.51 / $2,132.00
| Professional | | $486.23 | $583.51 | $2,132.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $57,255.43
| Facility | | $13,531.00 | $27,840.00 | $57,255.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.65 / $526.65 / $526.65
| Professional | | $447.65 | $526.65 | $526.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.15 / $650.57 / $1,044.70
| Professional | | $508.15 | $650.57 | $1,044.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $785.33 / $785.33 / $813.21
| Professional | | $785.33 | $785.33 | $813.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,123.89 / $21,781.82 / $43,157.70
| Facility | | $3,123.89 | $21,781.82 | $43,157.70 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $5,027.75 / $5,027.75 / $5,027.75
| Facility | 22 | $5,027.75 | $5,027.75 | $5,027.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $757.97 / $6,432.00 / $21,645.90
| Facility | | $757.97 | $6,432.00 | $21,645.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.23 / $700.00 / $2,271.00
| Professional | | $486.23 | $700.00 | $2,271.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $915.00 / $1,298.80
| Professional | | $4.00 | $915.00 | $1,298.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.82 / $663.79 / $1,044.70
| Professional | | $514.82 | $663.79 | $1,044.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.97 / $501.97 / $674.48
| Facility | | $501.97 | $501.97 | $674.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.51 / $508.60 / $674.48
| Professional | | $482.51 | $508.60 | $674.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,742.00 / $10,675.00 / $30,788.00
| Facility | | $3,742.00 | $10,675.00 | $30,788.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.71 / $665.73 / $1,065.96
| Professional | | $502.71 | $665.73 | $1,065.96 |