- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.82 / $2,561.00 / $8,294.00
| Facility | | $451.82 | $2,561.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.15 / $430.94 / $597.41
| Professional | | $361.15 | $430.94 | $597.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,900.00 / $13,875.00 / $15,752.00
| Facility | | $10,900.00 | $13,875.00 | $15,752.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.13 / $444.24 / $643.16
| Professional | | $333.13 | $444.24 | $643.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.66 / $542.00 / $11,515.00
| Professional | | $372.66 | $542.00 | $11,515.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.02 / $522.03 / $944.17
| Professional | | $362.02 | $522.03 | $944.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.15 / $482.58 / $595.17
| Professional | | $402.15 | $482.58 | $595.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.68 / $524.05 / $776.23
| Facility | | $392.68 | $524.05 | $776.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.00 / $606.00 / $803.00
| Professional | | $526.00 | $606.00 | $803.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.96 / $472.93 / $3,512.00
| Facility | | $356.96 | $472.93 | $3,512.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.71 / $585.08 / $3,512.00
| Professional | | $438.71 | $585.08 | $3,512.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,349.00 / $7,061.00 / $12,739.00
| Facility | | $4,349.00 | $7,061.00 | $12,739.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.98 / $604.44 / $919.88
| Professional | | $366.98 | $604.44 | $919.88 |