- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.47 / $3,596.00 / $10,836.00
| Facility | | $818.47 | $3,596.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.13 / $803.58 / $967.87
| Professional | | $582.13 | $803.58 | $967.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $4,240.06 / $8,895.81
| Facility | | $2,400.00 | $4,240.06 | $8,895.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.55 / $861.41 / $1,173.82
| Professional | | $680.55 | $861.41 | $1,173.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $733.85 / $733.85 / $733.85
| Facility | | $733.85 | $733.85 | $733.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $625.16 / $898.32 / $1,272.19
| Professional | | $625.16 | $898.32 | $1,272.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $9,178.62
| Facility | | $55.00 | $55.00 | $9,178.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,142.72 / $5,250.80 / $6,588.68
| Professional | | $5,142.72 | $5,250.80 | $6,588.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.72 / $816.02 / $1,598.35
| Facility | | $594.72 | $816.02 | $1,598.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $947.40 / $1,093.16 / $1,311.79
| Professional | | $947.40 | $1,093.16 | $1,311.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $863.69 / $1,368.08 / $2,916.26
| Professional | | $863.69 | $1,368.08 | $2,916.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.72 / $816.02 / $1,639.17
| Facility | | $594.72 | $816.02 | $1,639.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $625.41 / $904.64 / $1,423.74
| Professional | | $625.41 | $904.64 | $1,423.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.12 / $715.28 / $1,195.28
| Professional | | $503.12 | $715.28 | $1,195.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.98 / $703.07 / $971.65
| Professional | | $621.98 | $703.07 | $971.65 |