- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $4,304.00 / $8,240.00
| Facility | | $882.00 | $4,304.00 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.84 / $577.78 / $777.31
| Professional | | $506.84 | $577.78 | $777.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.82 / $580.94 / $989.58
| Professional | | $559.82 | $580.94 | $989.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.53 / $580.94 / $967.12
| Professional | | $443.53 | $580.94 | $967.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $677.07 / $677.07 / $873.10
| Professional | | $677.07 | $677.07 | $873.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,247.00
| Facility | | $1,013.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.97 / $686.85 / $4,831.00
| Professional | | $535.97 | $686.85 | $4,831.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $625.40 / $625.40 / $625.40
| Professional | | $625.40 | $625.40 | $625.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.78 / $589.88 / $967.12
| Professional | | $452.78 | $589.88 | $967.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.78 / $550.79 / $550.79
| Facility | | $518.78 | $550.79 | $550.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.78 / $550.79 / $585.71
| Professional | | $518.78 | $550.79 | $585.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.82 / $610.29 / $1,110.47
| Professional | | $470.82 | $610.29 | $1,110.47 |