- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $3,830.00 / $8,247.00
| Facility | | $594.00 | $3,830.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $414.55 / $469.17 / $1,372.84
| Professional | | $414.55 | $469.17 | $1,372.84 |
- 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
- $454.51 / $721.52 / $927.59
| Professional | | $454.51 | $721.52 | $927.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.78 / $587.34 / $916.43
| Professional | | $438.78 | $587.34 | $916.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $531.48 / $703.19 / $708.41
| Professional | | $531.48 | $703.19 | $708.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,598.56 / $7,326.48 / $11,603.12
| Facility | | $3,598.56 | $7,326.48 | $11,603.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.00 / $4,761.00 / $8,404.00
| Facility | | $926.00 | $4,761.00 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $414.55 / $597.91 / $1,905.00
| Professional | | $414.55 | $597.91 | $1,905.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $546.70 / $1,132.80
| Professional | | $4.00 | $546.70 | $1,132.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.60 / $593.01 / $918.28
| Professional | | $439.60 | $593.01 | $918.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.49 / $440.49 / $477.36
| Facility | | $440.49 | $440.49 | $477.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.87 / $441.88 / $477.36
| Professional | | $427.87 | $441.88 | $477.36 |
- 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
- $420.46 / $557.01 / $933.40
| Professional | | $420.46 | $557.01 | $933.40 |