- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.26 / $2,872.00 / $9,961.00
| Facility | | $466.26 | $2,872.00 | $9,961.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.61 / $344.98 / $501.37
| Professional | | $284.61 | $344.98 | $501.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,090.94 / $3,922.02 / $7,975.58
| Facility | | $2,090.94 | $3,922.02 | $7,975.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.72 / $375.55 / $563.94
| Professional | | $292.72 | $375.55 | $563.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.02 / $275.02 / $275.02
| Facility | | $275.02 | $275.02 | $275.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,403.30 / $2,403.30 / $2,403.30
| Facility | | $2,403.30 | $2,403.30 | $2,403.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.27 / $439.72 / $673.39
| Professional | | $326.27 | $439.72 | $673.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,529.38 / $26,542.00 / $26,542.00
| Facility | | $2,529.38 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,284.80 / $3,031.43 / $3,058.35
| Professional | | $2,284.80 | $3,031.43 | $3,058.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.97 / $409.78 / $714.38
| Facility | | $316.97 | $409.78 | $714.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.00 / $494.77 / $633.47
| Professional | | $402.00 | $494.77 | $633.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.80 / $450.80 / $450.80
| Professional | | $450.80 | $450.80 | $450.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.97 / $415.28 / $731.22
| Facility | | $316.97 | $415.28 | $731.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.05 / $450.36 / $738.28
| Professional | | $329.05 | $450.36 | $738.28 |
- 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
- $269.58 / $370.67 / $611.07
| Professional | | $269.58 | $370.67 | $611.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.36 / $340.51 / $474.75
| Professional | | $300.36 | $340.51 | $474.75 |