- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.32 / $2,747.00 / $6,148.62
| Facility | | $400.32 | $2,747.00 | $6,148.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.68 / $415.87 / $1,142.25
| Professional | | $345.68 | $415.87 | $1,142.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $984.43 / $3,245.00 / $26,542.00
| Facility | | $984.43 | $3,245.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.26 / $811.34 / $7,231.97
| Professional | | $413.26 | $811.34 | $7,231.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.29 / $807.31 / $1,093.61
| Professional | | $492.29 | $807.31 | $1,093.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.00 / $920.70 / $7,058.84
| Facility | | $837.00 | $920.70 | $7,058.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.88 / $683.10 / $1,458.19
| Professional | | $357.88 | $683.10 | $1,458.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.63 / $897.64 / $6,679.00
| Facility | | $415.63 | $897.64 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.94 / $605.91 / $885.29
| Professional | | $476.94 | $605.91 | $885.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $521.01 / $1,028.47 / $1,297.63
| Professional | | $521.01 | $1,028.47 | $1,297.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.43 / $5,142.85 / $5,232.68
| Facility | | $0.43 | $5,142.85 | $5,232.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.17 / $331.17 / $659.33
| Professional | | $331.17 | $331.17 | $659.33 |
- 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
- $432.71 / $814.76 / $7,231.97
| Professional | | $432.71 | $814.76 | $7,231.97 |
- 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
- $424.56 / $595.76 / $1,529.03
| Professional | | $424.56 | $595.76 | $1,529.03 |