- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,464.00 / $6,789.50 / $11,842.73
| Facility | | $2,464.00 | $6,789.50 | $11,842.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,420.34 / $7,004.31 / $8,731.54
| Professional | | $2,420.34 | $7,004.31 | $8,731.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,496.00 / $11,483.00 / $21,862.00
| Facility | | $9,496.00 | $11,483.00 | $21,862.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,738.91 / $25,644.26 / $33,131.62
| Facility | | $15,738.91 | $25,644.26 | $33,131.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,816.31 / $24,069.35 / $48,457.51
| Facility | | $12,816.31 | $24,069.35 | $48,457.51 |
- 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
- Facility
- Modifier
- Low / Median / High Price
- $4,187.12 / $4,829.14 / $10,380.00
| Facility | | $4,187.12 | $4,829.14 | $10,380.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,408.39 / $7,659.89 / $8,123.88
| Professional | | $1,408.39 | $7,659.89 | $8,123.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.73 / $1,020.58 / $14,056.53
| Professional | | $113.73 | $1,020.58 | $14,056.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,127.20 / $1,127.20 / $1,127.20
| Professional | | $1,127.20 | $1,127.20 | $1,127.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $687.20 / $1,466.27 / $1,744.57
| Professional | | $687.20 | $1,466.27 | $1,744.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,183.47 / $15,455.16 / $17,217.46
| Facility | | $15,183.47 | $15,455.16 | $17,217.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13,369.88 / $14,172.07 / $16,712.34
| Professional | | $13,369.88 | $14,172.07 | $16,712.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,873.00 / $10,316.00 / $19,562.00
| Facility | | $4,873.00 | $10,316.00 | $19,562.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $710.62 / $1,137.38 / $2,901.07
| Professional | | $710.62 | $1,137.38 | $2,901.07 |