- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,897.79 / $12,022.64
| Facility | | $602.56 | $4,897.79 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $371.54 / $1,318.26
| Professional | | $263.03 | $371.54 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $380.19
| Professional | | $371.54 | $371.54 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $467.74
| Professional | | $371.54 | $371.54 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $363.08 / $562.34
| Professional | | $275.42 | $363.08 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $389.05 / $426.58
| Professional | | $302.00 | $389.05 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $371.54 / $562.34
| Professional | | $281.84 | $371.54 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $7,413.10 / $15,488.17
| Facility | | $2,570.40 | $7,413.10 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,365.16 / $10,471.29
| Facility | | $602.56 | $4,365.16 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $398.11 / $1,202.26
| Professional | | $275.42 | $398.11 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $630.96
| Facility | | $562.34 | $562.34 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $537.03 / $602.56
| Professional | | $380.19 | $537.03 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $467.74 / $549.54
| Facility | | $275.42 | $467.74 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $288.40 / $467.74
| Professional | | $204.17 | $288.40 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $10,964.78
| Facility | | $1,348.96 | $3,548.13 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $338.84 / $575.44
| Professional | | $251.19 | $338.84 | $575.44 |