- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.51 / $3,623.00 / $7,799.00
| Facility | | $702.51 | $3,623.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $414.93 / $577.83 / $873.54
| Professional | | $414.93 | $577.83 | $873.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $560.87 / $789.81 / $1,345.11
| Professional | | $560.87 | $789.81 | $1,345.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.50 / $688.94 / $1,102.25
| Professional | | $465.50 | $688.94 | $1,102.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $765.45 / $1,015.42 / $1,033.24
| Professional | | $765.45 | $1,015.42 | $1,033.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,850.20 / $10,937.17 / $23,409.00
| Facility | | $6,850.20 | $10,937.17 | $23,409.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,017.00
| Facility | | $832.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.95 / $661.30 / $2,006.98
| Professional | | $435.95 | $661.30 | $2,006.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $533.60 / $1,717.60
| Professional | | $5.00 | $533.60 | $1,717.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $490.21 / $719.83 / $1,124.73
| Professional | | $490.21 | $719.83 | $1,124.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.27 / $458.64 / $633.79
| Facility | | $402.27 | $458.64 | $633.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.74 / $555.24 / $678.82
| Professional | | $446.74 | $555.24 | $678.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.91 / $762.41 / $1,278.80
| Professional | | $538.91 | $762.41 | $1,278.80 |