- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.35 / $1,181.00 / $6,519.00
| Facility | | $236.35 | $1,181.00 | $6,519.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.35 / $325.79 / $562.58
| Professional | | $236.35 | $325.79 | $562.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,021.07 / $1,123.17 / $1,905.99
| Facility | | $1,021.07 | $1,123.17 | $1,905.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.97 / $493.02 / $834.44
| Professional | | $318.97 | $493.02 | $834.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.24 / $1,359.55 / $2,702.90
| Facility | | $453.24 | $1,359.55 | $2,702.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.42 / $425.47 / $769.46
| Professional | | $271.42 | $425.47 | $769.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.35 / $344.52 / $572.36
| Facility | | $236.35 | $344.52 | $572.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.00 / $534.00 / $775.00
| Professional | | $450.00 | $534.00 | $775.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.20 / $332.50 / $779.50
| Professional | | $276.20 | $332.50 | $779.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.02 / $373.58 / $803.25
| Professional | | $278.02 | $373.58 | $803.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,684.44 / $1,684.44 / $16,394.00
| Facility | | $1,684.44 | $1,684.44 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,778.32 / $2,441.60 / $2,846.25
| Professional | | $1,778.32 | $2,441.60 | $2,846.25 |