- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,758.00 / $2,747.00 / $5,454.00
| Facility | | $1,758.00 | $2,747.00 | $5,454.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.97 / $417.15 / $1,449.00
| Professional | | $295.97 | $417.15 | $1,449.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.45 / $3,997.00 / $12,379.00
| Facility | | $680.45 | $3,997.00 | $12,379.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.52 / $563.61 / $3,506.00
| Professional | | $282.52 | $563.61 | $3,506.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.67 / $573.48 / $1,039.36
| Professional | | $380.67 | $573.48 | $1,039.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.72 / $594.79 / $6,679.00
| Facility | | $285.72 | $594.79 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.64 / $326.72 / $518.22
| Professional | | $172.64 | $326.72 | $518.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.21 / $698.46 / $1,055.50
| Professional | | $350.21 | $698.46 | $1,055.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.46 / $4,206.72 / $8,434.81
| Facility | | $842.46 | $4,206.72 | $8,434.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.50 / $468.43 / $867.90
| Professional | | $417.50 | $468.43 | $867.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,573.68 / $4,525.00 / $26,542.00
| Facility | | $1,573.68 | $4,525.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.16 / $594.79 / $3,506.00
| Professional | | $326.16 | $594.79 | $3,506.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.37 / $438.62 / $1,331.57
| Professional | | $308.37 | $438.62 | $1,331.57 |