- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.88 / $5,087.00 / $8,294.00
| Facility | | $592.88 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.41 / $567.07 / $699.86
| Professional | | $471.41 | $567.07 | $699.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.37 / $588.71 / $832.20
| Professional | | $460.37 | $588.71 | $832.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.29 / $545.07 / $1,847.84
| Professional | | $537.29 | $545.07 | $1,847.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $925.00 / $3,282.37
| Facility | | $490.00 | $925.00 | $3,282.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.95 / $638.41 / $1,074.57
| Professional | | $450.95 | $638.41 | $1,074.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.93 / $574.65 / $875.01
| Professional | | $471.93 | $574.65 | $875.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.82 / $656.84 / $1,007.61
| Facility | | $517.82 | $656.84 | $1,007.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $629.00 / $722.17 / $1,169.76
| Professional | | $629.00 | $722.17 | $1,169.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.78 / $642.37 / $1,162.09
| Facility | | $507.78 | $642.37 | $1,162.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.78 / $642.37 / $1,162.09
| Professional | | $507.78 | $642.37 | $1,162.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,745.00 / $10,466.00 / $21,401.00
| Facility | | $1,745.00 | $10,466.00 | $21,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.40 / $640.79 / $1,022.25
| Professional | | $403.40 | $640.79 | $1,022.25 |