- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.92 / $2,671.00 / $4,744.96
| Facility | | $247.92 | $2,671.00 | $4,744.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.76 / $325.49 / $584.07
| Professional | | $178.76 | $325.49 | $584.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.16 / $5,268.00 / $26,542.00
| Facility | | $607.16 | $5,268.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.61 / $573.23 / $1,761.28
| Professional | | $264.61 | $573.23 | $1,761.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.69 / $372.70 / $657.67
| Facility | | $286.69 | $372.70 | $657.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.93 / $525.62 / $832.61
| Professional | | $400.93 | $525.62 | $832.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $451.46 / $676.81 / $1,335.89
| Professional | | $451.46 | $676.81 | $1,335.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.53 / $522.76 / $6,679.00
| Facility | | $248.53 | $522.76 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.91 / $487.17 / $871.03
| Professional | | $403.91 | $487.17 | $871.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.20 / $668.71 / $1,109.40
| Professional | | $307.20 | $668.71 | $1,109.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,931.75 / $1,931.75 / $1,931.75
| Facility | | $1,931.75 | $1,931.75 | $1,931.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.62 / $253.62 / $253.62
| Professional | | $253.62 | $253.62 | $253.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $5,572.00 / $26,542.00
| Facility | | $1,485.00 | $5,572.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.46 / $846.29 / $2,575.88
| Professional | | $437.46 | $846.29 | $2,575.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $414.26 / $557.38 / $1,027.58
| Professional | | $414.26 | $557.38 | $1,027.58 |