- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.15 / $4,898.00 / $10,767.00
| Facility | | $564.15 | $4,898.00 | $10,767.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.35 / $1,737.15 / $2,919.97
| Professional | | $381.35 | $1,737.15 | $2,919.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.97 / $519.15 / $858.31
| Professional | | $405.97 | $519.15 | $858.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.93 / $600.00 / $1,046.00
| Professional | | $447.93 | $600.00 | $1,046.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.94 / $730.94 / $730.94
| Facility | | $730.94 | $730.94 | $730.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.30 / $1,649.85 / $3,535.18
| Professional | | $413.30 | $1,649.85 | $3,535.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,972.01 / $2,320.01 / $2,900.01
| Professional | | $1,972.01 | $2,320.01 | $2,900.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.05 / $1,934.84 / $3,699.60
| Facility | | $421.05 | $1,934.84 | $3,699.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,599.00 / $2,853.06 / $4,367.00
| Professional | | $2,599.00 | $2,853.06 | $4,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $403.33 / $531.66 / $9,929.00
| Facility | | $403.33 | $531.66 | $9,929.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,109.04 / $2,841.51 / $9,929.00
| Professional | | $2,109.04 | $2,841.51 | $9,929.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,693.00 / $11,671.00 / $21,639.00
| Facility | | $6,693.00 | $11,671.00 | $21,639.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,809.59 / $2,412.78 / $3,900.13
| Professional | | $1,809.59 | $2,412.78 | $3,900.13 |