- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $653.19 / $2,594.00 / $7,542.00
| Facility | | $653.19 | $2,594.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.31 / $471.88 / $678.31
| Professional | | $424.31 | $471.88 | $678.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,718.74 / $4,598.72 / $9,052.84
| Facility | | $2,718.74 | $4,598.72 | $9,052.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.86 / $622.58 / $709.35
| Professional | | $491.86 | $622.58 | $709.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.26 / $458.26 / $458.26
| Facility | | $458.26 | $458.26 | $458.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.79 / $2,266.79 / $2,266.79
| Facility | | $2,266.79 | $2,266.79 | $2,266.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.58 / $660.81 / $1,003.48
| Professional | | $523.58 | $660.81 | $1,003.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $8,957.00
| Facility | | $55.00 | $55.00 | $8,957.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,852.40 / $3,967.20 / $4,475.55
| Professional | | $3,852.40 | $3,967.20 | $4,475.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.44 / $557.78 / $1,086.90
| Facility | | $448.44 | $557.78 | $1,086.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $570.01 / $792.83 / $932.74
| Professional | | $570.01 | $792.83 | $932.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.47 / $580.24 / $1,270.09
| Facility | | $447.47 | $580.24 | $1,270.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.79 / $670.41 / $1,015.09
| Professional | | $524.79 | $670.41 | $1,015.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,425.00 / $10,600.00
| Facility | | $1,634.00 | $4,425.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.20 / $555.01 / $880.15
| Professional | | $404.20 | $555.01 | $880.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.26 / $502.45 / $699.79
| Professional | | $442.26 | $502.45 | $699.79 |