- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,421.00 / $2,663.12 / $5,454.00
| Facility | | $1,421.00 | $2,663.12 | $5,454.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.98 / $597.54 / $1,392.83
| Professional | | $471.98 | $597.54 | $1,392.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $3,715.00 / $9,039.00
| Facility | | $1,061.00 | $3,715.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.64 / $893.41 / $3,836.80
| Professional | | $457.64 | $893.41 | $3,836.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,028.32 / $1,048.26 / $1,556.46
| Professional | | $1,028.32 | $1,048.26 | $1,556.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $513.47 / $821.56 / $1,517.14
| Professional | | $513.47 | $821.56 | $1,517.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.07 / $1,143.44 / $6,679.00
| Facility | | $530.07 | $1,143.44 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $608.26 / $736.80 / $1,006.23
| Professional | | $608.26 | $736.80 | $1,006.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.68 / $1,309.73 / $1,727.74
| Professional | | $660.68 | $1,309.73 | $1,727.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,617.62 / $3,217.80 / $5,385.36
| Facility | | $2,617.62 | $3,217.80 | $5,385.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $819.58 / $861.83 / $1,190.76
| Professional | | $819.58 | $861.83 | $1,190.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,997.00 / $16,394.00
| Facility | | $1,902.00 | $3,997.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.49 / $915.51 / $3,836.80
| Professional | | $493.49 | $915.51 | $3,836.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.94 / $821.84 / $1,782.60
| Professional | | $468.94 | $821.84 | $1,782.60 |