- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,326.00 / $7,799.00
| Facility | | $540.00 | $2,326.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.34 / $467.46 / $596.94
| Professional | | $416.34 | $467.46 | $596.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.67 / $658.32 / $893.72
| Professional | | $412.67 | $658.32 | $893.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $451.72 / $616.55 / $961.04
| Professional | | $451.72 | $616.55 | $961.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.64 / $716.51 / $716.51
| Professional | | $541.64 | $716.51 | $716.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,326.00 / $8,017.00
| Facility | | $617.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.34 / $498.49 / $2,475.51
| Professional | | $416.34 | $498.49 | $2,475.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $635.00 / $1,151.70
| Professional | | $6.00 | $635.00 | $1,151.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.45 / $619.72 / $1,075.77
| Professional | | $463.45 | $619.72 | $1,075.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.47 / $455.47 / $708.37
| Facility | | $455.47 | $455.47 | $708.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.61 / $458.82 / $708.37
| Professional | | $440.61 | $458.82 | $708.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.94 / $588.91 / $974.32
| Professional | | $465.94 | $588.91 | $974.32 |