- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $4,761.00 / $9,534.00
| Facility | | $882.00 | $4,761.00 | $9,534.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.96 / $479.14 / $661.30
| Professional | | $430.96 | $479.14 | $661.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.00 / $5,951.00 / $8,887.00
| Facility | | $2,450.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.90 / $550.94 / $777.10
| Professional | | $530.90 | $550.94 | $777.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.85 / $647.91 / $1,012.32
| Professional | | $500.85 | $647.91 | $1,012.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $651.74 / $874.01 / $874.01
| Professional | | $651.74 | $874.01 | $874.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,261.60 / $6,480.84 / $19,190.61
| Facility | | $4,261.60 | $6,480.84 | $19,190.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,025.24 / $4,894.00 / $9,617.00
| Facility | | $1,025.24 | $4,894.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.63 / $553.40 / $1,537.86
| Professional | | $432.63 | $553.40 | $1,537.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $372.20 / $1,386.70
| Professional | | $3.00 | $372.20 | $1,386.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.23 / $651.10 / $1,098.68
| Professional | | $496.23 | $651.10 | $1,098.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.18 / $526.89 / $526.89
| Facility | | $430.18 | $526.89 | $526.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.18 / $526.89 / $561.64
| Professional | | $430.18 | $526.89 | $561.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.40 / $621.04 / $1,014.56
| Professional | | $438.40 | $621.04 | $1,014.56 |