- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $2,747.00 / $8,247.00
| Facility | | $1,301.00 | $2,747.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,178.35 / $1,886.39 / $2,659.27
| Professional | | $1,178.35 | $1,886.39 | $2,659.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $841.96 / $1,785.09 / $1,852.46
| Professional | | $841.96 | $1,785.09 | $1,852.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.19 / $2,200.19 / $2,200.19
| Facility | | $2,200.19 | $2,200.19 | $2,200.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,250.15 / $2,472.94 / $9,162.82
| Professional | | $2,250.15 | $2,472.94 | $9,162.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,293.01 / $3,149.38 / $3,960.65
| Professional | | $2,293.01 | $3,149.38 | $3,960.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,427.00
| Facility | | $1,013.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,218.08 / $1,886.91 / $2,925.47
| Professional | | $1,218.08 | $1,886.91 | $2,925.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.19 / $2,200.19 / $2,200.19
| Facility | | $2,200.19 | $2,200.19 | $2,200.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,250.15 / $2,472.94 / $9,162.82
| Professional | | $2,250.15 | $2,472.94 | $9,162.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.91 / $458.38 / $1,745.45
| Facility | | $431.91 | $458.38 | $1,745.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.91 / $1,745.45 / $1,898.50
| Professional | | $431.91 | $1,745.45 | $1,898.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.44 / $1,728.51 / $3,153.70
| Professional | | $512.44 | $1,728.51 | $3,153.70 |