- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.67 / $5,116.62 / $16,569.00
| Facility | | $327.67 | $5,116.62 | $16,569.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.45 / $310.36 / $651.24
| Professional | | $229.45 | $310.36 | $651.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,968.10 / $9,879.37 / $18,898.13
| Facility | | $5,968.10 | $9,879.37 | $18,898.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.04 / $565.57 / $2,104.00
| Professional | | $341.04 | $565.57 | $2,104.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,353.44 / $2,353.44 / $3,920.80
| Facility | | $2,353.44 | $2,353.44 | $3,920.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.31 / $497.07 / $730.04
| Professional | | $317.31 | $497.07 | $730.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.17 / $562.04 / $6,620.15
| Facility | | $302.17 | $562.04 | $6,620.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.14 / $542.14 / $2,641.65
| Professional | | $303.14 | $542.14 | $2,641.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.99 / $428.69 / $701.77
| Professional | | $66.99 | $428.69 | $701.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.63 / $473.72 / $496.40
| Facility | | $363.63 | $473.72 | $496.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $322.99 / $331.33 / $1,470.05
| Facility | | $322.99 | $331.33 | $1,470.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.04 / $552.66 / $679.54
| Professional | | $341.04 | $552.66 | $679.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,406.33 / $9,873.73 / $18,898.13
| Facility | | $6,406.33 | $9,873.73 | $18,898.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.41 / $476.62 / $641.99
| Professional | | $329.41 | $476.62 | $641.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $2,431.00 / $11,261.00
| Facility | | $1,550.00 | $2,431.00 | $11,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.52 / $506.26 / $700.91
| Professional | | $311.52 | $506.26 | $700.91 |