- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.05 / $7,489.85 / $18,800.00
| Facility | | $439.05 | $7,489.85 | $18,800.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.33 / $434.05 / $932.15
| Professional | | $326.33 | $434.05 | $932.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,886.41 / $16,351.48 / $31,278.54
| Facility | | $9,886.41 | $16,351.48 | $31,278.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.20 / $927.94 / $3,249.38
| Professional | | $529.20 | $927.94 | $3,249.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,066.66 / $4,066.66 / $6,775.01
| Facility | | $4,066.66 | $4,066.66 | $6,775.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.84 / $774.12 / $1,133.64
| Professional | | $456.84 | $774.12 | $1,133.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.78 / $816.04 / $12,028.17
| Facility | | $465.78 | $816.04 | $12,028.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.84 / $768.77 / $4,564.68
| Professional | | $467.84 | $768.77 | $4,564.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.57 / $486.89 / $869.14
| Professional | | $65.57 | $486.89 | $869.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.57 / $693.45 / $753.75
| Facility | | $516.57 | $693.45 | $753.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.38 / $514.13 / $2,429.53
| Facility | | $502.38 | $514.13 | $2,429.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.20 / $857.59 / $1,054.46
| Professional | | $529.20 | $857.59 | $1,054.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,603.20 / $16,342.14 / $31,278.54
| Facility | | $10,603.20 | $16,342.14 | $31,278.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.36 / $739.58 / $996.19
| Professional | | $512.36 | $739.58 | $996.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $4,686.00 / $20,708.00
| Facility | | $3,028.00 | $4,686.00 | $20,708.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.30 / $731.51 / $1,079.43
| Professional | | $465.30 | $731.51 | $1,079.43 |