- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.21 / $7,920.26 / $20,400.00
| Facility | | $746.21 | $7,920.26 | $20,400.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.32 / $442.48 / $1,802.91
| Professional | | $344.32 | $442.48 | $1,802.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.44 / $740.94 / $996.16
| Professional | | $476.44 | $740.94 | $996.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.63 / $771.27 / $868.37
| Professional | | $543.63 | $771.27 | $868.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.48 / $737.39 / $951.33
| Facility | | $442.48 | $737.39 | $951.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.59 / $653.91 / $1,083.25
| Professional | | $514.59 | $653.91 | $1,083.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.56 / $662.25 / $678.71
| Facility | | $482.56 | $662.25 | $678.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.48 / $827.51 / $5,626.00
| Facility | | $442.48 | $827.51 | $5,626.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.38 / $791.52 / $996.16
| Professional | | $601.38 | $791.52 | $996.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,273.56 / $9,753.18 / $13,050.49
| Facility | | $5,273.56 | $9,753.18 | $13,050.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $617.49 / $831.17 / $1,062.64
| Professional | | $617.49 | $831.17 | $1,062.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $9,074.00 / $12,786.00
| Facility | | $1,981.00 | $9,074.00 | $12,786.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.29 / $810.29 / $1,068.16
| Professional | | $526.29 | $810.29 | $1,068.16 |