- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.00 / $2,673.00 / $7,542.00
| Facility | | $714.00 | $2,673.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $677.10 / $795.49 / $1,327.07
| Professional | | $677.10 | $795.49 | $1,327.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,970.96 / $4,188.30 / $7,336.37
| Facility | | $1,970.96 | $4,188.30 | $7,336.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $732.87 / $927.64 / $1,264.07
| Professional | | $732.87 | $927.64 | $1,264.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $721.00 / $733.79
| Facility | | $80.00 | $721.00 | $733.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $901.69 / $901.69 / $901.69
| Facility | | $901.69 | $901.69 | $901.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $801.06 / $1,065.66 / $1,603.81
| Professional | | $801.06 | $1,065.66 | $1,603.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $8,957.00
| Facility | | $55.00 | $55.00 | $8,957.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,750.88 / $5,862.96 / $6,855.00
| Professional | | $5,750.88 | $5,862.96 | $6,855.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.62 / $937.93 / $1,478.60
| Facility | | $731.62 | $937.93 | $1,478.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $980.10 / $1,176.11 / $1,458.39
| Professional | | $980.10 | $1,176.11 | $1,458.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.80 / $851.80 / $851.80
| Professional | | $851.80 | $851.80 | $851.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.53 / $943.20 / $1,561.27
| Facility | | $735.53 | $943.20 | $1,561.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $809.19 / $1,091.56 / $1,648.03
| Professional | | $809.19 | $1,091.56 | $1,648.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,693.00 / $5,210.00 / $10,476.00
| Facility | | $1,693.00 | $5,210.00 | $10,476.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.86 / $833.31 / $1,326.66
| Professional | | $616.86 | $833.31 | $1,326.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $669.19 / $759.62 / $1,055.10
| Professional | | $669.19 | $759.62 | $1,055.10 |