- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.34 / $2,663.12 / $4,410.00
| Facility | | $455.34 | $2,663.12 | $4,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.10 / $478.73 / $722.58
| Professional | | $392.10 | $478.73 | $722.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $935.17 / $2,723.70 / $26,542.00
| Facility | | $935.17 | $2,723.70 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.50 / $933.54 / $3,460.72
| Professional | | $457.50 | $933.54 | $3,460.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $682.57 / $942.77 / $1,464.41
| Professional | | $682.57 | $942.77 | $1,464.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.00 / $748.00 / $3,111.82
| Facility | | $680.00 | $748.00 | $3,111.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.84 / $793.55 / $1,689.70
| Professional | | $427.84 | $793.55 | $1,689.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.69 / $1,045.00 / $6,679.00
| Facility | | $482.69 | $1,045.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $553.89 / $705.38 / $1,022.56
| Professional | | $553.89 | $705.38 | $1,022.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.75 / $1,191.80 / $1,578.87
| Professional | | $603.75 | $1,191.80 | $1,578.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.81 / $3,822.81 / $3,822.81
| Facility | | $3,822.81 | $3,822.81 | $3,822.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $703.81 / $703.81 / $703.81
| Professional | | $703.81 | $703.81 | $703.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $4,249.00 / $26,542.00
| Facility | | $1,061.00 | $4,249.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.15 / $933.54 / $3,460.72
| Professional | | $495.15 | $933.54 | $3,460.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $3,715.00 / $8,452.40
| Facility | | $1,061.00 | $3,715.00 | $8,452.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.80 / $688.55 / $1,624.71
| Professional | | $460.80 | $688.55 | $1,624.71 |