- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $5,754.40 / $8,511.38
| Facility | | $831.76 | $5,754.40 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $478.63 / $1,258.93
| Professional | | $398.11 | $478.63 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $21,379.62 / $57,543.99
| Facility | | $20,417.38 | $21,379.62 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $602.56 / $776.25
| Professional | | $354.81 | $602.56 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $562.34 / $812.83
| Professional | | $416.87 | $562.34 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $660.69
| Professional | | $575.44 | $575.44 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $562.34 / $933.25
| Professional | | $457.09 | $562.34 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $4,265.80 / $8,317.64
| Facility | | $831.76 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $537.03 / $1,380.38
| Professional | | $407.38 | $537.03 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $645.65 / $1,000.00
| Professional | | $630.96 | $645.65 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $416.87 / $549.54
| Facility | | $398.11 | $416.87 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $407.38 / $501.19
| Professional | | $371.54 | $407.38 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,570.40 / $6,760.83
| Facility | | $660.69 | $2,570.40 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $524.81 / $851.14
| Professional | | $389.05 | $524.81 | $851.14 |