- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.00 / $2,671.00 / $5,454.00
| Facility | | $699.00 | $2,671.00 | $5,454.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.84 / $542.69 / $1,792.56
| Professional | | $237.84 | $542.69 | $1,792.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $772.00 / $3,764.00 / $12,379.00
| Facility | | $772.00 | $3,764.00 | $12,379.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.08 / $637.44 / $3,132.62
| Professional | | $303.08 | $637.44 | $3,132.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.02 / $356.23 / $628.60
| Facility | | $274.02 | $356.23 | $628.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.31 / $569.05 / $802.95
| Professional | | $394.31 | $569.05 | $802.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.66 / $639.30 / $1,197.18
| Professional | | $349.66 | $639.30 | $1,197.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $349.76 / $6,679.00
| Facility | | $214.32 | $349.76 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.45 / $405.27 / $628.72
| Professional | | $210.45 | $405.27 | $628.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.47 / $629.25 / $910.26
| Professional | | $293.47 | $629.25 | $910.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,928.58 / $4,014.65 / $4,762.91
| Facility | | $1,928.58 | $4,014.65 | $4,762.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.35 / $691.12 / $800.78
| Professional | | $372.35 | $691.12 | $800.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.68 / $4,249.00 / $16,394.00
| Facility | | $1,172.68 | $4,249.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.93 / $1,062.54 / $3,132.62
| Professional | | $492.93 | $1,062.54 | $3,132.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.00 / $4,249.00 / $9,821.00
| Facility | | $1,700.00 | $4,249.00 | $9,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.99 / $711.90 / $1,183.57
| Professional | | $482.99 | $711.90 | $1,183.57 |