- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.87 / $485.81 / $616.62
| Professional | | $430.87 | $485.81 | $616.62 |
- 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
- $488.15 / $506.57 / $506.57
| Professional | | $488.15 | $506.57 | $506.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.83 / $629.17 / $987.25
| Professional | | $470.83 | $629.17 | $987.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $571.02 / $755.72 / $760.13
| Professional | | $571.02 | $755.72 | $760.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.87 / $524.16 / $2,564.30
| Professional | | $430.87 | $524.16 | $2,564.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $624.20 / $1,215.40
| Professional | | $4.00 | $624.20 | $1,215.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.77 / $636.33 / $1,011.99
| Professional | | $473.77 | $636.33 | $1,011.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.51 / $472.51 / $538.09
| Facility | | $472.51 | $472.51 | $538.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $458.90 / $474.06 / $538.09
| Professional | | $458.90 | $474.06 | $538.09 |
- 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
- $476.54 / $605.29 / $973.97
| Professional | | $476.54 | $605.29 | $973.97 |