- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,820.00 / $6,880.00 / $17,902.00
| Facility | | $1,820.00 | $6,880.00 | $17,902.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $648.79 / $648.79 / $11,824.21
| Professional | | $648.79 | $648.79 | $11,824.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,108.00 / $9,596.00 / $18,150.00
| Facility | | $4,108.00 | $9,596.00 | $18,150.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $596.25 / $1,786.77 / $2,962.43
| Professional | | $596.25 | $1,786.77 | $2,962.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.90 / $100.00 / $17,058.50
| Facility | | $65.90 | $100.00 | $17,058.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.73 / $811.41 / $12,680.53
| Professional | | $113.73 | $811.41 | $12,680.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13,369.88 / $13,369.88 / $16,712.34
| Professional | | $13,369.88 | $13,369.88 | $16,712.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $620.63 / $7,506.40 / $17,752.74
| Professional | | $620.63 | $7,506.40 | $17,752.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,646.27 / $69,693.39 / $81,121.39
| Facility | | $61,646.27 | $69,693.39 | $81,121.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52,438.32 / $72,861.20 / $87,301.95
| Professional | | $52,438.32 | $72,861.20 | $87,301.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $648.79 / $1,003.28 / $18,427.15
| Facility | | $648.79 | $1,003.28 | $18,427.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.44 / $702.55 / $15,216.64
| Professional | | $523.44 | $702.55 | $15,216.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,830.00 / $18,315.00 / $45,545.00
| Facility | | $8,830.00 | $18,315.00 | $45,545.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.30 / $831.30 / $2,857.71
| Professional | | $401.30 | $831.30 | $2,857.71 |