- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $2,673.00 / $7,495.00
| Facility | | $657.00 | $2,673.00 | $7,495.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.20 / $500.35 / $738.79
| Professional | | $437.20 | $500.35 | $738.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,477.32 / $6,279.16 / $11,746.74
| Facility | | $2,477.32 | $6,279.16 | $11,746.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.74 / $413.74 / $413.74
| Facility | | $413.74 | $413.74 | $413.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,194.69 / $3,194.69 / $3,194.69
| Facility | | $3,194.69 | $3,194.69 | $3,194.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.36 / $644.49 / $964.95
| Professional | | $496.36 | $644.49 | $964.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,018.19 / $12,623.50 / $16,394.00
| Facility | | $11,018.19 | $12,623.50 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,701.76 / $3,755.44 / $4,174.43
| Professional | | $3,701.76 | $3,755.44 | $4,174.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.52 / $588.89 / $1,013.11
| Facility | | $472.52 | $588.89 | $1,013.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $637.48 / $750.27 / $912.09
| Professional | | $637.48 | $750.27 | $912.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.10 / $558.10 / $558.10
| Professional | | $558.10 | $558.10 | $558.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.52 / $599.82 / $1,062.08
| Facility | | $472.52 | $599.82 | $1,062.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.36 / $652.76 / $1,029.74
| Professional | | $496.36 | $652.76 | $1,029.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,314.00 / $7,600.00
| Facility | | $1,154.00 | $3,314.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $384.30 / $517.25 / $850.30
| Professional | | $384.30 | $517.25 | $850.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.52 / $490.71 / $664.55
| Professional | | $418.52 | $490.71 | $664.55 |