- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $463.78 / $5,087.00 / $8,294.00
| Facility | | $463.78 | $5,087.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.05 / $463.78 / $571.78
| Professional | | $357.05 | $463.78 | $571.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.21 / $520.73 / $714.18
| Professional | | $407.21 | $520.73 | $714.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.99 / $730.68 / $3,426.00
| Professional | | $493.99 | $730.68 | $3,426.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.97 / $555.54 / $1,064.31
| Professional | | $416.97 | $555.54 | $1,064.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.12 / $498.14 / $614.38
| Professional | | $415.12 | $498.14 | $614.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.07 / $561.76 / $799.29
| Facility | | $407.07 | $561.76 | $799.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.00 / $580.00 / $1,030.42
| Professional | | $511.00 | $580.00 | $1,030.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.41 / $568.40 / $3,512.00
| Facility | | $432.41 | $568.40 | $3,512.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.41 / $568.40 / $3,512.00
| Professional | | $432.41 | $568.40 | $3,512.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,349.00 / $7,061.00 / $12,739.00
| Facility | | $4,349.00 | $7,061.00 | $12,739.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.29 / $547.26 / $886.31
| Professional | | $353.29 | $547.26 | $886.31 |