- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.00 / $2,172.00 / $7,513.00
| Facility | | $521.00 | $2,172.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.05 / $512.41 / $714.55
| Professional | | $468.05 | $512.41 | $714.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.60 / $518.16 / $776.75
| Professional | | $389.60 | $518.16 | $776.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.02 / $424.02 / $424.02
| Facility | | $424.02 | $424.02 | $424.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,376.10 / $2,376.10 / $2,376.10
| Facility | | $2,376.10 | $2,376.10 | $2,376.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.26 / $656.64 / $1,006.60
| Professional | | $505.26 | $656.64 | $1,006.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $9,388.90
| Facility | | $55.00 | $55.00 | $9,388.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,531.36 / $3,613.44 / $4,016.10
| Professional | | $3,531.36 | $3,613.44 | $4,016.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $469.81 / $637.29 / $1,087.22
| Facility | | $469.81 | $637.29 | $1,087.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $611.41 / $719.59 / $846.58
| Professional | | $611.41 | $719.59 | $846.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $664.90 / $664.90 / $664.90
| Professional | | $664.90 | $664.90 | $664.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $469.81 / $649.17 / $1,227.94
| Facility | | $469.81 | $649.17 | $1,227.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.32 / $675.93 / $1,025.80
| Professional | | $506.32 | $675.93 | $1,025.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.00 / $1,529.00 / $3,287.00
| Facility | | $369.00 | $1,529.00 | $3,287.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.02 / $560.49 / $859.51
| Professional | | $397.02 | $560.49 | $859.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.40 / $461.00 / $634.51
| Professional | | $401.40 | $461.00 | $634.51 |