- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.67 / $1,823.00 / $3,363.00
| Facility | | $361.67 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.38 / $392.54 / $571.53
| Professional | | $302.38 | $392.54 | $571.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $1,027.76 / $12,000.00
| Facility | | $308.00 | $1,027.76 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.36 / $745.13 / $2,927.52
| Professional | | $349.36 | $745.13 | $2,927.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.96 / $465.12 / $829.61
| Facility | | $361.96 | $465.12 | $829.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.74 / $353.73 / $353.73
| Professional | | $204.74 | $353.73 | $353.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $482.73 / $607.77
| Facility | | $443.00 | $482.73 | $607.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.70 / $624.85 / $1,199.61
| Professional | | $345.70 | $624.85 | $1,199.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.87 / $660.00 / $6,679.00
| Facility | | $304.87 | $660.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.41 / $600.22 / $924.30
| Professional | | $466.41 | $600.22 | $924.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.63 / $815.82 / $1,098.71
| Professional | | $421.63 | $815.82 | $1,098.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $2,093.16 / $12,000.00
| Facility | | $308.00 | $2,093.16 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.05 / $1,006.11 / $2,927.52
| Professional | | $463.05 | $1,006.11 | $2,927.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $1,078.00 / $2,733.00
| Facility | | $308.00 | $1,078.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.64 / $618.13 / $1,395.56
| Professional | | $418.64 | $618.13 | $1,395.56 |