- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $797.00 / $3,186.00 / $10,893.00
| Facility | | $797.00 | $3,186.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $698.14 / $857.50 / $1,415.72
| Professional | | $698.14 | $857.50 | $1,415.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,079.35 / $3,772.13 / $7,694.15
| Facility | | $2,079.35 | $3,772.13 | $7,694.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $643.29 / $726.00 / $1,405.90
| Professional | | $643.29 | $726.00 | $1,405.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $804.21 / $804.21 / $804.21
| Facility | | $804.21 | $804.21 | $804.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $871.16 / $1,185.82 / $1,796.01
| Professional | | $871.16 | $1,185.82 | $1,796.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $7,592.40
| Facility | | $55.00 | $55.00 | $7,592.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,258.96 / $6,442.48 / $7,878.30
| Professional | | $6,258.96 | $6,442.48 | $7,878.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.63 / $1,130.11 / $2,012.45
| Facility | | $851.63 | $1,130.11 | $2,012.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,143.34 / $1,345.64 / $1,583.10
| Professional | | $1,143.34 | $1,345.64 | $1,583.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,275.59 / $1,275.59 / $1,275.59
| Professional | | $1,275.59 | $1,275.59 | $1,275.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $858.01 / $1,137.68 / $2,059.92
| Facility | | $858.01 | $1,137.68 | $2,059.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $872.39 / $1,212.91 / $1,832.46
| Professional | | $872.39 | $1,212.91 | $1,832.46 |
- 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
- $750.74 / $1,007.60 / $1,611.73
| Professional | | $750.74 | $1,007.60 | $1,611.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.63 / $858.01 / $1,170.69
| Professional | | $750.63 | $858.01 | $1,170.69 |