- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.97 / $2,324.23 / $10,268.00
| Facility | | $730.97 | $2,324.23 | $10,268.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.33 / $730.97 / $1,297.24
| Professional | | $602.33 | $730.97 | $1,297.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $2,742.00 / $8,800.00
| Facility | | $1,152.00 | $2,742.00 | $8,800.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $462.71 / $670.15 / $1,261.24
| Professional | | $462.71 | $670.15 | $1,261.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.32 / $919.86 / $1,525.80
| Facility | | $750.32 | $919.86 | $1,525.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.28 / $837.86 / $1,307.07
| Professional | | $579.28 | $837.86 | $1,307.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.32 / $1,124.08 / $21,571.00
| Facility | | $1,037.32 | $1,124.08 | $21,571.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $577.16 / $836.90 / $1,468.97
| Professional | | $577.16 | $836.90 | $1,468.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,124.08 / $1,124.08 / $1,253.49
| Facility | | $1,124.08 | $1,124.08 | $1,253.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $577.16 / $852.95 / $1,327.50
| Professional | | $577.16 | $852.95 | $1,327.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.18 / $517.70 / $899.36
| Professional | | $76.18 | $517.70 | $899.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $4,072.00 / $6,522.00
| Facility | | $1,981.00 | $4,072.00 | $6,522.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $611.28 / $778.02 / $1,676.46
| Professional | | $611.28 | $778.02 | $1,676.46 |