- 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
- $369.92 / $422.15 / $565.83
| Professional | | $369.92 | $422.15 | $565.83 |
- 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
- $455.98 / $473.19 / $687.98
| Professional | | $455.98 | $473.19 | $687.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.17 / $562.41 / $913.41
| Professional | | $430.17 | $562.41 | $913.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $542.58 / $721.18 / $721.18
| Professional | | $542.58 | $721.18 | $721.18 |
- 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
- $387.88 / $451.24 / $2,357.92
| Professional | | $387.88 | $451.24 | $2,357.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $466.60 / $1,175.59
| Professional | | $4.00 | $466.60 | $1,175.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.65 / $577.54 / $927.33
| Professional | | $435.65 | $577.54 | $927.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.13 / $450.49 / $450.49
| Facility | | $380.13 | $450.49 | $450.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.13 / $450.49 / $476.02
| Professional | | $380.13 | $450.49 | $476.02 |
- 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
- $397.26 / $545.23 / $897.07
| Professional | | $397.26 | $545.23 | $897.07 |