- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.35 / $2,079.00 / $3,625.00
| Facility | | $480.35 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.94 / $516.73 / $761.04
| Professional | | $427.94 | $516.73 | $761.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.35 / $1,374.93 / $7,161.00
| Facility | | $818.35 | $1,374.93 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.04 / $657.74 / $3,078.08
| Professional | | $363.04 | $657.74 | $3,078.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.02 / $652.91 / $1,153.93
| Facility | | $503.02 | $652.91 | $1,153.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $599.10 / $872.24 / $1,208.25
| Professional | | $599.10 | $872.24 | $1,208.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.27 / $355.27 / $355.27
| Facility | | $355.27 | $355.27 | $355.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.16 / $817.59 / $1,488.56
| Professional | | $419.16 | $817.59 | $1,488.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $642.04 / $6,679.00
| Facility | | $214.32 | $642.04 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.22 / $660.25 / $911.40
| Professional | | $525.22 | $660.25 | $911.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.14 / $1,043.53 / $1,377.22
| Professional | | $518.14 | $1,043.53 | $1,377.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.25 / $672.25 / $672.25
| Professional | | $672.25 | $672.25 | $672.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $2,510.00 / $11,500.00
| Facility | | $789.00 | $2,510.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.63 / $738.34 / $3,443.12
| Professional | | $473.63 | $738.34 | $3,443.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.00 / $2,078.00 / $5,683.00
| Facility | | $700.00 | $2,078.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.20 / $621.40 / $1,420.14
| Professional | | $463.20 | $621.40 | $1,420.14 |