- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.18 / $2,747.00 / $8,017.00
| Facility | | $506.18 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.82 / $452.10 / $615.41
| Professional | | $390.82 | $452.10 | $615.41 |
- 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
- $454.93 / $472.10 / $823.03
| Professional | | $454.93 | $472.10 | $823.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.18 / $450.64 / $741.42
| Professional | | $344.18 | $450.64 | $741.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.79 / $555.79 / $716.70
| Professional | | $555.79 | $555.79 | $716.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.77 / $491.30 / $2,466.39
| Professional | | $394.77 | $491.30 | $2,466.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.00 / $539.00 / $539.00
| Professional | | $539.00 | $539.00 | $539.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.90 / $469.77 / $741.42
| Professional | | $347.90 | $469.77 | $741.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.70 / $442.57 / $472.71
| Facility | | $392.70 | $442.57 | $472.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.65 / $442.57 / $478.33
| Professional | | $389.65 | $442.57 | $478.33 |
- 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
- $371.20 / $514.36 / $895.85
| Professional | | $371.20 | $514.36 | $895.85 |