- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $782.79 / $3,748.00 / $8,017.00
| Facility | | $782.79 | $3,748.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $683.82 / $787.80 / $1,207.50
| Professional | | $683.82 | $787.80 | $1,207.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $815.88 / $846.67 / $846.67
| Professional | | $815.88 | $846.67 | $846.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $798.17 / $1,039.09 / $1,660.95
| Professional | | $798.17 | $1,039.09 | $1,660.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $997.82 / $1,341.76 / $1,341.76
| Professional | | $997.82 | $1,341.76 | $1,341.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,839.00 / $8,017.00
| Facility | | $954.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $700.00 / $843.35 / $1,805.93
| Professional | | $700.00 | $843.35 | $1,805.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $915.90 / $2,055.19
| Professional | | $6.00 | $915.90 | $2,055.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $798.17 / $1,042.78 / $1,720.68
| Professional | | $798.17 | $1,042.78 | $1,720.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.13 / $803.71 / $803.71
| Facility | | $755.13 | $803.71 | $803.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $755.13 / $803.71 / $849.32
| Professional | | $755.13 | $803.71 | $849.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,222.00 / $3,475.00 / $6,000.00
| Facility | | $2,222.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $729.08 / $1,024.91 / $1,630.90
| Professional | | $729.08 | $1,024.91 | $1,630.90 |