- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.92 / $2,422.00 / $7,799.00
| Facility | | $597.92 | $2,422.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.32 / $528.37 / $694.07
| Professional | | $492.32 | $528.37 | $694.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.30 / $746.62 / $1,006.82
| Professional | | $472.30 | $746.62 | $1,006.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.92 / $681.94 / $1,126.30
| Professional | | $492.92 | $681.94 | $1,126.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $643.77 / $854.13 / $867.23
| Professional | | $643.77 | $854.13 | $867.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,757.55 / $6,757.55 / $6,757.55
| Facility | | $6,757.55 | $6,757.55 | $6,757.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,371.00 / $8,017.00
| Facility | | $617.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.31 / $583.45 / $1,544.00
| Professional | | $492.31 | $583.45 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $567.79 / $1,459.20
| Professional | | $5.00 | $567.79 | $1,459.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.70 / $705.49 / $1,131.65
| Professional | | $525.70 | $705.49 | $1,131.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.69 / $536.69 / $548.26
| Facility | | $536.69 | $536.69 | $548.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.79 / $536.69 / $574.14
| Professional | | $525.79 | $536.69 | $574.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.09 / $667.59 / $1,130.77
| Professional | | $452.09 | $667.59 | $1,130.77 |