- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $912.01 / $6,606.93
| Facility | | $416.87 | $912.01 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $398.11 / $812.83
| Professional | | $204.17 | $398.11 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $1,949.84
| Facility | | $851.14 | $851.14 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $489.78 / $1,000.00
| Professional | | $257.04 | $489.78 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $512.86 / $1,071.52
| Professional | | $354.81 | $512.86 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $489.78 / $933.25
| Facility | | $229.09 | $489.78 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $630.96 / $954.99
| Professional | | $346.74 | $630.96 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $758.58 / $831.76
| Facility | | $512.86 | $758.58 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $457.09 / $912.01
| Facility | | $213.80 | $457.09 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $537.03 / $1,023.29
| Professional | | $79.43 | $537.03 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,019.95 / $3,548.13
| Facility | | $2,137.96 | $3,019.95 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $676.08 / $1,023.29
| Professional | | $398.11 | $676.08 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $4,570.88 / $7,244.36
| Facility | | $1,548.82 | $4,570.88 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $562.34 / $1,000.00
| Professional | | $316.23 | $562.34 | $1,000.00 |