- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.54 / $2,671.00 / $6,188.67
| Facility | | $716.54 | $2,671.00 | $6,188.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $646.01 / $991.03 / $2,497.32
| Professional | | $646.01 | $991.03 | $2,497.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $3,315.28 / $8,498.00
| Facility | | $1,089.00 | $3,315.28 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $704.64 / $1,422.15 / $5,567.76
| Professional | | $704.64 | $1,422.15 | $5,567.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $905.26 / $1,176.83 / $2,076.67
| Facility | | $905.26 | $1,176.83 | $2,076.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,114.21 / $1,659.70 / $2,313.88
| Professional | | $1,114.21 | $1,659.70 | $2,313.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $871.16 / $1,381.05 / $2,877.66
| Professional | | $871.16 | $1,381.05 | $2,877.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $764.43 / $1,650.64 / $6,679.00
| Facility | | $764.43 | $1,650.64 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,031.27 / $1,295.17 / $1,787.84
| Professional | | $1,031.27 | $1,295.17 | $1,787.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $944.54 / $1,946.41 / $2,753.98
| Professional | | $944.54 | $1,946.41 | $2,753.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.95 / $2,057.23 / $4,501.87
| Facility | | $1,779.95 | $2,057.23 | $4,501.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,414.89 / $1,494.77 / $2,296.59
| Professional | | $1,414.89 | $1,494.77 | $2,296.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $4,569.00 / $26,542.00
| Facility | | $1,640.00 | $4,569.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,011.46 / $1,774.20 / $6,741.60
| Professional | | $1,011.46 | $1,774.20 | $6,741.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $844.52 / $1,314.52 / $2,753.62
| Professional | | $844.52 | $1,314.52 | $2,753.62 |