- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,316.25 / $4,585.53 / $12,605.30
| Facility | | $1,316.25 | $4,585.53 | $12,605.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $956.48 / $1,456.65 / $1,491.75
| Professional | | $956.48 | $1,456.65 | $1,491.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $8,792.54
| Facility | | $244.00 | $614.00 | $8,792.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.26 / $403.51 / $1,654.05
| Professional | | $336.26 | $403.51 | $1,654.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $2,316.60 / $15,742.35
| Facility | | $59.40 | $2,316.60 | $15,742.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $887.25 / $1,267.50 / $3,169.38
| Professional | | $887.25 | $1,267.50 | $3,169.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.23 / $3,257.48 / $6,286.80
| Facility | | $1,175.23 | $3,257.48 | $6,286.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,950.00 / $2,340.00 / $3,120.00
| Professional | | $1,950.00 | $2,340.00 | $3,120.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,755.00 / $2,242.50 / $3,724.50
| Professional | | $1,755.00 | $2,242.50 | $3,724.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,393.00 / $9,262.50 / $9,262.50
| Facility | | $3,393.00 | $9,262.50 | $9,262.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,711.00 / $9,711.00 / $14,625.00
| Professional | | $9,711.00 | $9,711.00 | $14,625.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,404.00 / $2,340.00 / $5,034.13
| Facility | | $1,404.00 | $2,340.00 | $5,034.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,930.50 / $1,950.00 / $2,632.50
| Professional | | $1,930.50 | $1,950.00 | $2,632.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $737.10 / $766.88 / $3,522.29
| Professional | | $737.10 | $766.88 | $3,522.29 |