- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.41 / $4,771.00 / $9,539.00
| Facility | | $528.41 | $4,771.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $462.67 / $528.41 / $748.33
| Professional | | $462.67 | $528.41 | $748.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,312.32 / $2,001.45 / $5,768.00
| Facility | | $1,312.32 | $2,001.45 | $5,768.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.35 / $544.10 / $758.37
| Professional | | $427.35 | $544.10 | $758.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $570.86 / $581.86 / $1,134.63
| Professional | | $570.86 | $581.86 | $1,134.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.61 / $667.97 / $1,072.27
| Professional | | $480.61 | $667.97 | $1,072.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.29 / $527.15 / $650.15
| Professional | | $439.29 | $527.15 | $650.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.41 / $649.39 / $995.36
| Facility | | $528.41 | $649.39 | $995.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.00 / $701.00 / $1,080.07
| Professional | | $626.00 | $701.00 | $1,080.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.53 / $675.58 / $3,658.00
| Facility | | $500.53 | $675.58 | $3,658.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.53 / $675.58 / $3,658.00
| Professional | | $500.53 | $675.58 | $3,658.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $3,130.00 / $5,226.00
| Facility | | $1,547.00 | $3,130.00 | $5,226.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.46 / $695.90 / $1,030.44
| Professional | | $415.46 | $695.90 | $1,030.44 |