- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,113.02 / $5,412.00 / $11,024.00
| Facility | | $3,113.02 | $5,412.00 | $11,024.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,328.77 / $2,831.11 / $3,651.04
| Professional | | $2,328.77 | $2,831.11 | $3,651.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,738.20 / $20,977.18 / $29,216.95
| Facility | | $12,738.20 | $20,977.18 | $29,216.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,501.28 / $3,236.36 / $5,350.67
| Professional | | $2,501.28 | $3,236.36 | $5,350.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,146.61 / $3,222.46 / $9,951.00
| Professional | | $3,146.61 | $3,222.46 | $9,951.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $3,106.91
| Facility | | $640.00 | $640.00 | $3,106.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,493.39 / $3,301.40 / $6,043.36
| Professional | | $2,493.39 | $3,301.40 | $6,043.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,599.38 / $3,327.21 / $3,905.14
| Professional | | $2,599.38 | $3,327.21 | $3,905.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,571.77 / $3,470.15 / $5,175.10
| Facility | | $2,571.77 | $3,470.15 | $5,175.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,854.00 / $3,745.43 / $5,128.00
| Professional | | $2,854.00 | $3,745.43 | $5,128.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.46 / $3,316.14 / $7,902.00
| Facility | | $2,400.46 | $3,316.14 | $7,902.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,400.46 / $3,316.14 / $7,902.00
| Professional | | $2,400.46 | $3,316.14 | $7,902.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,408.00 / $13,296.00 / $26,537.00
| Facility | | $7,408.00 | $13,296.00 | $26,537.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,040.91 / $3,259.79 / $5,421.89
| Professional | | $2,040.91 | $3,259.79 | $5,421.89 |