- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,698.24 / $15,848.93
| Facility | | $371.54 | $1,698.24 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $794.33 / $1,995.26
| Professional | | $208.93 | $794.33 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $125.89 / $186.21
| Professional | | $100.00 | $125.89 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $794.33 / $2,884.03
| Professional | | $380.19 | $794.33 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $363.08 / $363.08
| Facility | | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $707.95 / $2,454.71
| Professional | | $269.15 | $707.95 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,778.28 / $1,778.28 / $1,778.28
| Professional | | $1,778.28 | $1,778.28 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $851.14 / $2,187.76
| Facility | | $229.09 | $851.14 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Professional | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $1,995.26 / $4,365.16
| Professional | | $302.00 | $1,995.26 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $758.58 / $1,949.84
| Facility | | $204.17 | $758.58 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $776.25 / $2,089.30
| Professional | | $218.78 | $776.25 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $8,709.64 / $8,709.64
| Facility | | $56.23 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,079.46 / $7,079.46 / $8,317.64
| Professional | | $7,079.46 | $7,079.46 | $8,317.64 |