- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.58 / $1,932.00 / $3,469.00
| Facility | | $478.58 | $1,932.00 | $3,469.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.40 / $255.64 / $589.94
| Professional | | $165.40 | $255.64 | $589.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.00 / $1,689.00 / $16,394.00
| Facility | | $432.00 | $1,689.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.93 / $670.96 / $3,159.52
| Professional | | $212.93 | $670.96 | $3,159.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.83 / $249.07 / $494.27
| Facility | | $193.83 | $249.07 | $494.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $605.88 / $1,263.74 / $1,263.74
| Professional | | $605.88 | $1,263.74 | $1,263.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $1,527.80 / $2,000.00
| Facility | | $593.00 | $1,527.80 | $2,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.39 / $455.00 / $1,198.38
| Professional | | $220.39 | $455.00 | $1,198.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.97 / $506.00 / $6,679.00
| Facility | | $168.97 | $506.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.75 / $639.44 / $947.89
| Professional | | $491.75 | $639.44 | $947.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.75 / $540.66 / $1,197.58
| Professional | | $249.75 | $540.66 | $1,197.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,800.74 / $1,800.74 / $3,103.34
| Facility | | $1,800.74 | $1,800.74 | $3,103.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.00 / $2,338.00 / $16,394.00
| Facility | | $822.00 | $2,338.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.43 / $1,053.17 / $3,159.52
| Professional | | $267.43 | $1,053.17 | $3,159.52 |
- 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
- $251.80 / $623.27 / $1,410.00
| Professional | | $251.80 | $623.27 | $1,410.00 |