- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,748.00 / $8,017.00
| Facility | | $768.00 | $3,748.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.16 / $536.17 / $879.66
| Professional | | $457.16 | $536.17 | $879.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.78 / $584.01 / $584.01
| Professional | | $562.78 | $584.01 | $584.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.91 / $716.74 / $1,089.92
| Professional | | $530.91 | $716.74 | $1,089.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $667.63 / $887.26 / $887.26
| Professional | | $667.63 | $887.26 | $887.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,457.54 / $9,457.54 / $13,406.73
| Facility | | $9,457.54 | $9,457.54 | $13,406.73 |
- 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
- $485.00 / $610.73 / $2,000.79
| Professional | | $485.00 | $610.73 | $2,000.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $695.20 / $1,444.30
| Professional | | $6.00 | $695.20 | $1,444.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.86 / $718.48 / $1,143.22
| Professional | | $537.86 | $718.48 | $1,143.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.91 / $556.91 / $646.61
| Facility | | $556.91 | $556.91 | $646.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.50 / $560.05 / $646.61
| Professional | | $539.50 | $560.05 | $646.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,000.00
| Facility | | $2,155.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.98 / $640.71 / $1,076.28
| Professional | | $499.98 | $640.71 | $1,076.28 |