- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,058.76 / $4,304.00 / $8,240.00
| Facility | | $1,058.76 | $4,304.00 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $955.94 / $1,012.47 / $1,414.09
| Professional | | $955.94 | $1,012.47 | $1,414.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,153.03 / $1,196.54 / $1,196.54
| Professional | | $1,153.03 | $1,196.54 | $1,196.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $947.95 / $1,225.60 / $2,205.21
| Professional | | $947.95 | $1,225.60 | $2,205.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,381.61 / $1,776.36 / $1,838.27
| Professional | | $1,381.61 | $1,776.36 | $1,838.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,761.00 / $8,247.00
| Facility | | $1,020.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $966.60 / $1,129.25 / $6,059.76
| Professional | | $966.60 | $1,129.25 | $6,059.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,186.00 / $1,186.00 / $1,244.70
| Professional | | $1,186.00 | $1,186.00 | $1,244.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,303.43 / $1,303.43 / $1,303.43
| Facility | | $1,303.43 | $1,303.43 | $1,303.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $995.91 / $1,256.86 / $2,277.67
| Professional | | $995.91 | $1,256.86 | $2,277.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,117.08 / $1,127.49 / $1,127.49
| Facility | | $1,117.08 | $1,127.49 | $1,127.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,117.08 / $1,127.49 / $1,195.47
| Professional | | $1,117.08 | $1,127.49 | $1,195.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,440.00 / $3,475.00 / $6,368.00
| Facility | | $1,440.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $987.32 / $1,219.63 / $2,175.21
| Professional | | $987.32 | $1,219.63 | $2,175.21 |