- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.67 / $2,747.00 / $8,247.00
| Facility | | $814.67 | $2,747.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.44 / $769.48 / $1,165.07
| Professional | | $630.44 | $769.48 | $1,165.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $796.76 / $826.83 / $826.83
| Professional | | $796.76 | $826.83 | $826.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,134.27 / $1,134.27 / $1,134.27
| Facility | | $1,134.27 | $1,134.27 | $1,134.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.61 / $931.96 / $1,582.71
| Professional | | $680.61 | $931.96 | $1,582.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $940.28 / $1,250.08 / $1,624.12
| Professional | | $940.28 | $1,250.08 | $1,624.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,407.76 / $12,495.40 / $16,066.13
| Facility | | $5,407.76 | $12,495.40 | $16,066.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,675.00 / $8,017.00
| Facility | | $918.00 | $2,675.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $642.64 / $836.94 / $2,005.04
| Professional | | $642.64 | $836.94 | $2,005.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $771.10 / $771.10 / $1,880.50
| Professional | | $771.10 | $771.10 | $1,880.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,134.27 / $1,134.27 / $1,134.27
| Facility | | $1,134.27 | $1,134.27 | $1,134.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $682.02 / $952.45 / $1,637.05
| Professional | | $682.02 | $952.45 | $1,637.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.36 / $715.68 / $838.02
| Facility | | $644.36 | $715.68 | $838.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $643.70 / $752.18 / $816.41
| Professional | | $643.70 | $752.18 | $816.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $719.79 / $988.01 / $1,647.92
| Professional | | $719.79 | $988.01 | $1,647.92 |