- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $925.26 / $2,812.16 / $18,711.00
| Facility | | $925.26 | $2,812.16 | $18,711.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.35 / $562.14 / $1,227.29
| Professional | | $466.35 | $562.14 | $1,227.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.59 / $909.12 / $2,010.57
| Facility | | $209.59 | $909.12 | $2,010.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $713.38 / $1,232.79 / $4,653.75
| Professional | | $713.38 | $1,232.79 | $4,653.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.17 / $313.17 / $521.74
| Facility | | $313.17 | $313.17 | $521.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $665.56 / $1,050.93 / $1,538.20
| Professional | | $665.56 | $1,050.93 | $1,538.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.53 / $984.98 / $1,376.01
| Facility | | $351.53 | $984.98 | $1,376.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.14 / $984.98 / $1,315.46
| Professional | | $463.14 | $984.98 | $1,315.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.33 / $837.77 / $1,385.97
| Professional | | $132.33 | $837.77 | $1,385.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $654.55 / $923.61 / $1,045.86
| Facility | | $654.55 | $923.61 | $1,045.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.59 / $695.36 / $713.38
| Facility | | $209.59 | $695.36 | $713.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $749.50 / $1,189.95 / $1,463.13
| Professional | | $749.50 | $1,189.95 | $1,463.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $663.37 / $908.60 / $1,739.05
| Facility | | $663.37 | $908.60 | $1,739.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $709.17 / $1,026.20 / $1,382.27
| Professional | | $709.17 | $1,026.20 | $1,382.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.00 / $666.00 / $6,216.00
| Facility | | $190.00 | $666.00 | $6,216.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $638.40 / $1,018.40 / $1,500.40
| Professional | | $638.40 | $1,018.40 | $1,500.40 |