- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.54 / $1,615.00 / $10,924.00
| Facility | | $458.54 | $1,615.00 | $10,924.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.80 / $462.43 / $764.65
| Professional | | $436.80 | $462.43 | $764.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $865.16 / $865.16 / $1,366.95
| Facility | | $865.16 | $865.16 | $1,366.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.09 / $823.79 / $1,148.78
| Professional | | $485.09 | $823.79 | $1,148.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.00 / $2,011.11 / $3,793.95
| Facility | | $498.00 | $2,011.11 | $3,793.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.63 / $675.54 / $1,185.36
| Professional | | $450.63 | $675.54 | $1,185.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.23 / $550.25 / $806.88
| Facility | | $450.23 | $550.25 | $806.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.00 / $643.00 / $2,101.82
| Professional | | $400.00 | $643.00 | $2,101.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.40 / $615.90 / $958.60
| Professional | | $456.40 | $615.90 | $958.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $902.00 / $1,557.00 / $11,999.00
| Facility | | $902.00 | $1,557.00 | $11,999.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.64 / $535.57 / $1,240.01
| Professional | | $386.64 | $535.57 | $1,240.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,750.36 / $2,500.00 / $11,102.00
| Facility | | $1,750.36 | $2,500.00 | $11,102.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,332.48 / $3,332.48 / $4,053.90
| Professional | | $3,332.48 | $3,332.48 | $4,053.90 |