- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $3,801.89 / $8,511.38
| Facility | | $457.09 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $389.05 / $1,230.27
| Professional | | $190.55 | $389.05 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $281.84
| Professional | | $234.42 | $234.42 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $4,073.80 / $7,943.28
| Facility | | $3,090.30 | $4,073.80 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $501.19 / $1,174.90
| Professional | | $229.09 | $501.19 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $691.83 / $1,819.70
| Professional | | $275.42 | $691.83 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $537.03 / $1,380.38
| Facility | | $186.21 | $537.03 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | 52 | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $1,202.26 / $4,570.88
| Professional | | $371.54 | $1,202.26 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $1,148.15 / $1,905.46
| Professional | | $380.19 | $1,148.15 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $1,122.02 / $1,445.44
| Professional | | $346.74 | $1,122.02 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $512.86 / $1,778.28
| Professional | | $5.01 | $512.86 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,162.28 / $8,128.31
| Facility | | $2,398.83 | $3,162.28 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $512.86 / $1,479.11
| Professional | | $239.88 | $512.86 | $1,479.11 |