- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $4,761.00 / $8,451.00
| Facility | | $921.00 | $4,761.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $670.21 / $759.30 / $1,221.66
| Professional | | $670.21 | $759.30 | $1,221.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $797.36 / $827.45 / $827.45
| Professional | | $797.36 | $827.45 | $827.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $752.23 / $1,021.39 / $1,613.15
| Professional | | $752.23 | $1,021.39 | $1,613.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $942.84 / $1,253.30 / $1,253.30
| Professional | | $942.84 | $1,253.30 | $1,253.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $946.44 / $946.44 / $8,349.87
| Facility | | $946.44 | $946.44 | $8,349.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.00 / $5,350.00 / $9,617.00
| Facility | | $1,054.00 | $5,350.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $685.00 / $853.93 / $2,660.00
| Professional | | $685.00 | $853.93 | $2,660.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $849.40 / $2,027.10
| Professional | | $6.00 | $849.40 | $2,027.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $760.44 / $1,031.82 / $1,749.36
| Professional | | $760.44 | $1,031.82 | $1,749.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $788.62 / $788.62 / $853.23
| Facility | | $788.62 | $788.62 | $853.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $762.47 / $794.62 / $853.23
| Professional | | $762.47 | $794.62 | $853.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $733.66 / $1,016.25 / $1,605.61
| Professional | | $733.66 | $1,016.25 | $1,605.61 |