- 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
- $663.58 / $1,771.40 / $2,162.60
| Professional | | $663.58 | $1,771.40 | $2,162.60 |
- 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
- $1,034.17 / $2,677.64 / $2,778.69
| Professional | | $1,034.17 | $2,677.64 | $2,778.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.48 / $2,248.48 / $2,248.48
| Facility | | $2,248.48 | $2,248.48 | $2,248.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,250.15 / $2,472.94 / $9,360.83
| Professional | | $2,250.15 | $2,472.94 | $9,360.83 |
- 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
- $698.50 / $1,771.40 / $2,305.56
| Professional | | $698.50 | $1,771.40 | $2,305.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.48 / $2,248.48 / $2,248.48
| Facility | | $2,248.48 | $2,248.48 | $2,248.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,250.15 / $2,472.94 / $9,360.83
| Professional | | $2,250.15 | $2,472.94 | $9,360.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.71 / $647.86 / $2,618.19
| Facility | | $507.71 | $647.86 | $2,618.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.71 / $687.58 / $2,847.75
| Professional | | $507.71 | $687.58 | $2,847.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,447.00 / $3,198.00 / $6,000.00
| Facility | | $1,447.00 | $3,198.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $613.73 / $2,592.77 / $4,730.56
| Professional | | $613.73 | $2,592.77 | $4,730.56 |