- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.58 / $3,839.00 / $8,247.00
| Facility | | $694.58 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.38 / $646.07 / $822.37
| Professional | | $575.38 | $646.07 | $822.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $649.27 / $673.77 / $673.77
| Professional | | $649.27 | $673.77 | $673.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.02 / $846.07 / $1,312.07
| Professional | | $626.02 | $846.07 | $1,312.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.50 / $1,003.73 / $1,009.10
| Professional | | $758.50 | $1,003.73 | $1,009.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,860.62 / $3,860.62 / $3,860.62
| Facility | | $3,860.62 | $3,860.62 | $3,860.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.58 / $4,761.00 / $8,247.00
| Facility | | $694.58 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.38 / $692.67 / $2,843.00
| Professional | | $575.38 | $692.67 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $915.60 / $1,381.50
| Professional | | $3.00 | $915.60 | $1,381.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $636.24 / $875.17 / $1,502.45
| Professional | | $636.24 | $875.17 | $1,502.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.95 / $629.95 / $754.46
| Facility | | $629.95 | $629.95 | $754.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $611.62 / $632.24 / $754.46
| Professional | | $611.62 | $632.24 | $754.46 |
- 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
- $633.89 / $806.97 / $1,298.42
| Professional | | $633.89 | $806.97 | $1,298.42 |