- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,745.00 / $8,017.00
| Facility | | $768.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $395.82 / $452.51 / $602.07
| Professional | | $395.82 | $452.51 | $602.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.67 / $511.26 / $1,090.85
| Professional | | $492.67 | $511.26 | $1,090.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $464.78 / $625.57 / $935.13
| Professional | | $464.78 | $625.57 | $935.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.97 / $766.20 / $774.31
| Professional | | $578.97 | $766.20 | $774.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,964.00 / $8,017.00
| Facility | | $954.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.65 / $487.37 / $2,543.63
| Professional | | $411.65 | $487.37 | $2,543.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $550.50 / $1,255.90
| Professional | | $4.00 | $550.50 | $1,255.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.13 / $626.85 / $986.27
| Professional | | $468.13 | $626.85 | $986.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $459.90 / $480.99 / $480.99
| Facility | | $459.90 | $480.99 | $480.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.90 / $480.99 / $506.94
| Professional | | $459.90 | $480.99 | $506.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $6,885.00 / $23,801.00
| Facility | | $2,468.00 | $6,885.00 | $23,801.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.73 / $603.38 / $1,028.83
| Professional | | $448.73 | $603.38 | $1,028.83 |