- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $4,063.00 / $10,398.00
| Facility | | $1,301.00 | $4,063.00 | $10,398.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $619.16 / $2,385.57 / $3,270.33
| Professional | | $619.16 | $2,385.57 | $3,270.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,448.29 / $2,540.67 / $2,540.67
| Professional | | $2,448.29 | $2,540.67 | $2,540.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.52 / $1,144.52 / $1,144.52
| Facility | | $1,144.52 | $1,144.52 | $1,144.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.74 / $2,309.71 / $4,750.21
| Professional | | $680.74 | $2,309.71 | $4,750.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,980.81 / $3,971.97 / $5,148.68
| Professional | | $2,980.81 | $3,971.97 | $5,148.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,426.00 / $5,350.00 / $11,083.00
| Facility | | $1,426.00 | $5,350.00 | $11,083.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $649.38 / $2,409.00 / $5,363.64
| Professional | | $649.38 | $2,409.00 | $5,363.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $859.20 / $859.20 / $7,387.40
| Professional | | $859.20 | $859.20 | $7,387.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.52 / $1,144.52 / $1,144.52
| Facility | | $1,144.52 | $1,144.52 | $1,144.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $687.32 / $2,346.58 / $4,803.87
| Professional | | $687.32 | $2,346.58 | $4,803.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.51 / $683.95 / $2,519.73
| Facility | | $651.51 | $683.95 | $2,519.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $651.15 / $2,214.71 / $2,741.60
| Professional | | $651.15 | $2,214.71 | $2,741.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,715.00 / $5,678.00
| Facility | | $1,175.00 | $2,715.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,393.82 / $3,335.82 / $5,406.01
| Professional | | $2,393.82 | $3,335.82 | $5,406.01 |