- 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
- $410.27 / $461.09 / $587.71
| Professional | | $410.27 | $461.09 | $587.71 |
- 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
- $407.06 / $648.35 / $879.27
| Professional | | $407.06 | $648.35 | $879.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.54 / $607.51 / $947.51
| Professional | | $445.54 | $607.51 | $947.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.23 / $706.67 / $706.67
| Professional | | $534.23 | $706.67 | $706.67 |
- 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
- $410.27 / $491.19 / $2,441.69
| Professional | | $410.27 | $491.19 | $2,441.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $621.20 / $1,134.90
| Professional | | $6.00 | $621.20 | $1,134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.94 / $612.96 / $1,062.14
| Professional | | $460.94 | $612.96 | $1,062.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.57 / $448.57 / $679.72
| Facility | | $448.57 | $448.57 | $679.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.07 / $451.73 / $679.72
| Professional | | $434.07 | $451.73 | $679.72 |
- 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
- $462.11 / $580.63 / $940.90
| Professional | | $462.11 | $580.63 | $940.90 |