- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,748.00 / $8,017.00
| Facility | | $768.00 | $3,748.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.24 / $568.29 / $891.25
| Professional | | $500.24 | $568.29 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $570.28 / $591.79 / $1,054.19
| Professional | | $570.28 | $591.79 | $1,054.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.87 / $737.92 / $1,154.33
| Professional | | $550.87 | $737.92 | $1,154.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $666.35 / $881.63 / $887.57
| Professional | | $666.35 | $881.63 | $887.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,263.33 / $11,631.56 / $19,911.09
| Facility | | $6,263.33 | $11,631.56 | $19,911.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,839.00 / $8,017.00
| Facility | | $954.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $521.84 / $622.17 / $2,383.94
| Professional | | $521.84 | $622.17 | $2,383.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $792.10 / $1,424.00
| Professional | | $3.00 | $792.10 | $1,424.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $564.90 / $744.50 / $1,204.69
| Professional | | $564.90 | $744.50 | $1,204.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.41 / $553.41 / $688.78
| Facility | | $553.41 | $553.41 | $688.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.44 / $555.28 / $688.78
| Professional | | $537.44 | $555.28 | $688.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,000.00
| Facility | | $2,155.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.04 / $704.14 / $1,224.40
| Professional | | $539.04 | $704.14 | $1,224.40 |