- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $3,090.30 / $5,128.61
| Facility | | $467.74 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $524.81 / $1,148.15
| Professional | | $338.84 | $524.81 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,981.07 / $45,708.82
| Facility | | $831.76 | $3,981.07 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $630.96 / $3,890.45
| Professional | | $363.08 | $630.96 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $954.99
| Facility | | $416.87 | $416.87 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,122.02 / $1,659.59
| Professional | | $724.44 | $1,122.02 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $3,090.30
| Facility | | $676.08 | $741.31 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $575.44 / $1,318.26
| Professional | | $331.13 | $575.44 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $707.95 / $7,079.46
| Facility | | $331.13 | $707.95 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $851.14 / $1,174.90
| Professional | | $616.60 | $851.14 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $707.95 / $1,445.44
| Professional | | $389.05 | $707.95 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,981.07 / $45,708.82
| Facility | | $831.76 | $3,981.07 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $630.96 / $3,890.45
| Professional | | $363.08 | $630.96 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,890.45 / $9,549.93
| Facility | | $1,071.52 | $3,890.45 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $645.65 / $1,380.38
| Professional | | $363.08 | $645.65 | $1,380.38 |