- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $799.00 / $3,596.00 / $10,836.00
| Facility | | $799.00 | $3,596.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $769.49 / $1,032.49
| Professional | | $691.83 | $769.49 | $1,032.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $719.20 / $1,277.73 / $7,901.00
| Facility | | $719.20 | $1,277.73 | $7,901.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.88 / $805.30 / $1,121.97
| Professional | | $631.88 | $805.30 | $1,121.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.49 / $625.49 / $625.49
| Facility | | $625.49 | $625.49 | $625.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $718.70 / $969.35 / $1,519.92
| Professional | | $718.70 | $969.35 | $1,519.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $5,609.45
| Facility | | $55.00 | $55.00 | $5,609.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,648.44 / $5,648.44 / $5,844.90
| Professional | | $5,648.44 | $5,648.44 | $5,844.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.20 / $939.24 / $1,622.03
| Facility | | $708.20 | $939.24 | $1,622.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.76 / $1,044.24 / $1,228.52
| Professional | | $750.76 | $1,044.24 | $1,228.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,096.90 / $1,096.90 / $1,096.90
| Professional | | $1,096.90 | $1,096.90 | $1,096.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.20 / $942.37 / $1,744.49
| Facility | | $708.20 | $942.37 | $1,744.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $723.10 / $983.52 / $1,571.66
| Professional | | $723.10 | $983.52 | $1,571.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.51 / $806.01 / $1,304.97
| Professional | | $598.51 | $806.01 | $1,304.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.50 / $666.12 / $921.62
| Professional | | $582.50 | $666.12 | $921.62 |