- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,912.94 / $5,282.00 / $10,637.11
| Facility | | $1,912.94 | $5,282.00 | $10,637.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,544.67 / $1,755.21 / $2,202.67
| Professional | | $1,544.67 | $1,755.21 | $2,202.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,524.00 / $22,312.00 / $37,718.00
| Facility | | $12,524.00 | $22,312.00 | $37,718.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,538.17 / $1,966.97 / $3,251.99
| Professional | | $1,538.17 | $1,966.97 | $3,251.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,844.97 / $1,869.00 / $15,406.00
| Professional | | $1,844.97 | $1,869.00 | $15,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $900.00 / $1,877.47
| Facility | | $900.00 | $900.00 | $1,877.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,567.19 / $2,121.64 / $3,589.43
| Professional | | $1,567.19 | $2,121.64 | $3,589.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,545.93 / $1,978.79 / $2,299.73
| Professional | | $1,545.93 | $1,978.79 | $2,299.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,651.68 / $2,183.87 / $3,247.53
| Facility | | $1,651.68 | $2,183.87 | $3,247.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,141.00 / $2,416.00 / $3,276.00
| Professional | | $2,141.00 | $2,416.00 | $3,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,527.79 / $2,100.44 / $6,585.00
| Facility | | $1,527.79 | $2,100.44 | $6,585.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,527.79 / $2,100.44 / $6,585.00
| Professional | | $1,527.79 | $2,100.44 | $6,585.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,398.00 / $10,000.00 / $21,639.00
| Facility | | $6,398.00 | $10,000.00 | $21,639.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,262.70 / $1,987.10 / $3,121.98
| Professional | | $1,262.70 | $1,987.10 | $3,121.98 |