- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $570.14 / $4,603.00 / $12,474.55
| Facility | | $570.14 | $4,603.00 | $12,474.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.05 / $516.25 / $1,316.27
| Professional | | $345.05 | $516.25 | $1,316.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.03 / $618.47 / $762.19
| Professional | | $402.03 | $618.47 | $762.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.57 / $569.90 / $859.95
| Professional | | $374.57 | $569.90 | $859.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.47 / $593.02 / $593.82
| Professional | | $448.47 | $593.02 | $593.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,445.00 / $14,140.73 / $21,986.46
| Facility | | $5,445.00 | $14,140.73 | $21,986.46 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $6,215.63 / $6,215.63 / $6,215.63
| Facility | 22 | $6,215.63 | $6,215.63 | $6,215.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.36 / $4,315.35 / $10,638.00
| Facility | | $672.36 | $4,315.35 | $10,638.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.56 / $545.08 / $1,316.27
| Professional | | $375.56 | $545.08 | $1,316.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $867.40 / $1,172.80
| Professional | | $5.00 | $867.40 | $1,172.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.05 / $577.54 / $940.86
| Professional | | $410.05 | $577.54 | $940.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.58 / $377.58 / $876.92
| Facility | | $377.58 | $377.58 | $876.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.40 / $380.22 / $876.92
| Professional | | $365.40 | $380.22 | $876.92 |
- 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
- $400.22 / $520.95 / $826.77
| Professional | | $400.22 | $520.95 | $826.77 |