- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $5,128.61 / $8,912.51
| Facility | | $660.69 | $5,128.61 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $660.69 / $1,230.27
| Professional | | $524.81 | $660.69 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $724.44 / $1,023.29
| Professional | | $549.54 | $724.44 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $954.99 / $6,918.31
| Professional | | $616.60 | $954.99 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $741.31 / $1,174.90
| Professional | | $537.03 | $741.31 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $630.96 / $1,584.89
| Professional | | $501.19 | $630.96 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $912.01 / $1,318.26
| Professional | | $741.31 | $912.01 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $831.76 / $1,202.26
| Facility | | $575.44 | $831.76 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $758.58 / $10,000.00
| Facility | | $524.81 | $758.58 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $758.58 / $10,000.00
| Professional | | $524.81 | $758.58 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $9,549.93 / $19,054.61
| Facility | | $5,623.41 | $9,549.93 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $741.31 / $1,202.26
| Professional | | $467.74 | $741.31 | $1,202.26 |