- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.15 / $3,839.00 / $8,247.00
| Facility | | $402.15 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.52 / $396.06 / $591.76
| Professional | | $281.52 | $396.06 | $591.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.12 / $498.97 / $818.04
| Professional | | $424.12 | $498.97 | $818.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.45 / $418.91 / $674.89
| Professional | | $317.45 | $418.91 | $674.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.47 / $557.47 / $793.57
| Professional | | $557.47 | $557.47 | $793.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,247.00
| Facility | | $657.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.52 / $425.88 / $1,194.38
| Professional | | $281.52 | $425.88 | $1,194.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.10 / $398.10 / $436.00
| Professional | | $398.10 | $398.10 | $436.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.82 / $420.15 / $674.89
| Professional | | $325.82 | $420.15 | $674.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.42 / $470.15 / $470.15
| Facility | | $453.42 | $470.15 | $470.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.11 / $470.15 / $623.01
| Professional | | $213.11 | $470.15 | $623.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.00 / $2,391.00 / $6,322.00
| Facility | | $656.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.92 / $497.98 / $907.90
| Professional | | $273.92 | $497.98 | $907.90 |