- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $2,954.00 / $8,451.00
| Facility | | $652.00 | $2,954.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.39 / $496.08 / $946.35
| Professional | | $172.39 | $496.08 | $946.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $682.87 / $708.64 / $708.64
| Professional | | $682.87 | $708.64 | $708.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.78 / $523.99 / $1,374.38
| Professional | | $188.78 | $523.99 | $1,374.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $835.11 / $1,107.42 / $1,145.35
| Professional | | $835.11 | $1,107.42 | $1,145.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,627.21 / $7,012.25 / $11,723.70
| Facility | | $2,627.21 | $7,012.25 | $11,723.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $2,679.00 / $8,247.00
| Facility | | $652.00 | $2,679.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.87 / $587.64 / $1,353.49
| Professional | | $176.87 | $587.64 | $1,353.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $1,234.50 / $2,099.69
| Professional | | $3.00 | $1,234.50 | $2,099.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.81 / $538.11 / $1,407.45
| Professional | | $194.81 | $538.11 | $1,407.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.44 / $393.44 / $761.62
| Facility | | $169.44 | $393.44 | $761.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.44 / $708.57 / $781.78
| Professional | | $169.44 | $708.57 | $781.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $605.21 / $903.01 / $1,544.79
| Professional | | $605.21 | $903.01 | $1,544.79 |