- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $566.41 / $3,645.00 / $8,294.00
| Facility | | $566.41 | $3,645.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.98 / $515.42 / $725.23
| Professional | | $432.98 | $515.42 | $725.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,032.00 / $6,548.00 / $7,221.00
| Facility | | $5,032.00 | $6,548.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.86 / $524.38 / $730.88
| Professional | | $411.86 | $524.38 | $730.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.96 / $778.63 / $5,354.00
| Professional | | $496.96 | $778.63 | $5,354.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.23 / $624.42 / $1,036.20
| Professional | | $446.23 | $624.42 | $1,036.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.14 / $507.77 / $626.25
| Professional | | $423.14 | $507.77 | $626.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.38 / $634.65 / $943.24
| Facility | | $510.38 | $634.65 | $943.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.00 / $660.00 / $1,039.58
| Professional | | $583.00 | $660.00 | $1,039.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.61 / $637.91 / $7,420.00
| Facility | | $443.61 | $637.91 | $7,420.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.61 / $637.91 / $7,420.00
| Professional | | $443.61 | $637.91 | $7,420.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,737.00 / $9,373.00 / $17,192.00
| Facility | | $5,737.00 | $9,373.00 | $17,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.76 / $676.83 / $995.20
| Professional | | $402.76 | $676.83 | $995.20 |