- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.68 / $2,747.00 / $7,144.92
| Facility | | $373.68 | $2,747.00 | $7,144.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.73 / $409.53 / $1,086.35
| Professional | | $346.73 | $409.53 | $1,086.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $960.68 / $3,245.00 / $26,542.00
| Facility | | $960.68 | $3,245.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.16 / $795.80 / $4,720.07
| Professional | | $416.16 | $795.80 | $4,720.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.93 / $785.40 / $1,063.94
| Professional | | $478.93 | $785.40 | $1,063.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.00 / $920.70 / $3,751.11
| Facility | | $837.00 | $920.70 | $3,751.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.75 / $670.35 / $1,426.36
| Professional | | $412.75 | $670.35 | $1,426.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.94 / $873.28 / $6,679.00
| Facility | | $405.94 | $873.28 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.82 / $589.46 / $864.65
| Professional | | $465.82 | $589.46 | $864.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.18 / $1,009.07 / $1,273.14
| Professional | | $511.18 | $1,009.07 | $1,273.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,341.72 / $4,341.72 / $4,341.72
| Facility | | $4,341.72 | $4,341.72 | $4,341.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.36 / $324.36 / $324.36
| Professional | | $324.36 | $324.36 | $324.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $5,572.00 / $26,542.00
| Facility | | $1,485.00 | $5,572.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.86 / $806.18 / $4,720.07
| Professional | | $441.86 | $806.18 | $4,720.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $3,245.00 / $7,608.00
| Facility | | $1,485.00 | $3,245.00 | $7,608.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.11 / $607.58 / $1,393.68
| Professional | | $429.11 | $607.58 | $1,393.68 |