- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,836.42 / $5,696.88 / $17,586.80
| Facility | | $1,836.42 | $5,696.88 | $17,586.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,334.47 / $2,032.30 / $2,081.28
| Professional | | $1,334.47 | $2,032.30 | $2,081.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $12,267.29
| Facility | | $244.00 | $614.00 | $12,267.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.07 / $10.88 / $4,015.63
| Professional | | $9.07 | $10.88 | $4,015.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.00 / $3,697.33 / $6,733.54
| Facility | | $97.00 | $3,697.33 | $6,733.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,114.08 / $1,591.56 / $3,979.70
| Professional | | $1,114.08 | $1,591.56 | $3,979.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,639.66 / $2,832.98 / $6,191.17
| Facility | | $1,639.66 | $2,832.98 | $6,191.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,448.56 / $2,693.42 / $3,305.56
| Professional | | $2,448.56 | $2,693.42 | $3,305.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,203.69 / $2,815.84 / $4,676.75
| Professional | | $2,203.69 | $2,815.84 | $4,676.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,260.49 / $11,630.66 / $11,630.66
| Facility | | $4,260.49 | $11,630.66 | $11,630.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,193.83 / $12,193.83 / $18,364.20
| Professional | | $12,193.83 | $12,193.83 | $18,364.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,958.85 / $2,938.27 / $5,463.98
| Facility | | $1,958.85 | $2,938.27 | $5,463.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,448.56 / $2,693.42 / $3,672.84
| Professional | | $2,448.56 | $2,693.42 | $3,672.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,958.85 / $2,497.53 / $4,162.55
| Professional | | $1,958.85 | $2,497.53 | $4,162.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,028.40 / $1,028.40 / $4,864.80
| Professional | | $1,028.40 | $1,028.40 | $4,864.80 |