- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.53 / $3,964.00 / $8,017.00
| Facility | | $505.53 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.25 / $385.53 / $609.75
| Professional | | $276.25 | $385.53 | $609.75 |
- 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
- $311.51 / $323.27 / $522.46
| Professional | | $311.51 | $323.27 | $522.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.00 / $470.97 / $725.82
| Professional | | $304.00 | $470.97 | $725.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.69 / $487.62 / $487.62
| Professional | | $366.69 | $487.62 | $487.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,780.01 / $8,654.26 / $17,377.16
| Facility | | $3,780.01 | $8,654.26 | $17,377.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.00 / $4,102.00 / $8,017.00
| Facility | | $749.00 | $4,102.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.83 / $425.37 / $1,075.02
| Professional | | $276.83 | $425.37 | $1,075.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $494.10 / $828.40
| Professional | | $4.00 | $494.10 | $828.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.26 / $470.97 / $817.04
| Professional | | $323.26 | $470.97 | $817.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.23 / $306.23 / $418.46
| Facility | | $306.23 | $306.23 | $418.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.55 / $309.37 / $418.46
| Professional | | $295.55 | $309.37 | $418.46 |
- 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
- $316.52 / $420.64 / $673.83
| Professional | | $316.52 | $420.64 | $673.83 |