- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.78 / $3,839.00 / $8,247.00
| Facility | | $822.78 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $682.93 / $819.10 / $1,003.97
| Professional | | $682.93 | $819.10 | $1,003.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $770.01 / $799.06 / $1,444.55
| Professional | | $770.01 | $799.06 | $1,444.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $742.93 / $994.28 / $1,587.78
| Professional | | $742.93 | $994.28 | $1,587.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $897.21 / $1,187.00 / $1,192.26
| Professional | | $897.21 | $1,187.00 | $1,192.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,195.46 / $10,195.46 / $10,195.46
| Facility | | $10,195.46 | $10,195.46 | $10,195.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.78 / $4,761.00 / $8,247.00
| Facility | | $822.78 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $682.93 / $822.78 / $1,985.44
| Professional | | $682.93 | $822.78 | $1,985.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $978.50 / $1,914.50
| Professional | | $6.00 | $978.50 | $1,914.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.34 / $1,004.07 / $1,618.05
| Professional | | $750.34 | $1,004.07 | $1,618.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $747.97 / $747.97 / $867.38
| Facility | | $747.97 | $747.97 | $867.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $725.52 / $751.39 / $867.38
| Professional | | $725.52 | $751.39 | $867.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,595.00 / $5,762.00
| Facility | | $2,332.00 | $3,595.00 | $5,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $737.65 / $948.80 / $1,548.96
| Professional | | $737.65 | $948.80 | $1,548.96 |