- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.24 / $1,823.00 / $3,363.00
| Facility | | $266.24 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.09 / $317.44 / $484.09
| Professional | | $220.09 | $317.44 | $484.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.39 / $1,689.00 / $12,000.00
| Facility | | $525.39 | $1,689.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.20 / $579.66 / $2,405.76
| Professional | | $289.20 | $579.66 | $2,405.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.07 / $344.47 / $614.41
| Facility | | $268.07 | $344.47 | $614.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.37 / $928.83 / $928.83
| Professional | | $452.37 | $928.83 | $928.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $1,463.30
| Facility | | $443.00 | $500.00 | $1,463.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.01 / $493.46 / $992.05
| Professional | | $287.01 | $493.46 | $992.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.86 / $488.80 / $6,679.00
| Facility | | $230.86 | $488.80 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.77 / $494.60 / $790.31
| Professional | | $383.77 | $494.60 | $790.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.67 / $614.72 / $902.72
| Professional | | $328.67 | $614.72 | $902.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.00 / $2,338.00 / $12,000.00
| Facility | | $822.00 | $2,338.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.27 / $819.64 / $2,405.76
| Professional | | $394.27 | $819.64 | $2,405.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.00 / $2,338.00 / $4,952.00
| Facility | | $669.00 | $2,338.00 | $4,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.13 / $505.90 / $1,192.05
| Professional | | $335.13 | $505.90 | $1,192.05 |