- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,278.00 / $4,250.00 / $10,398.00
| Facility | | $1,278.00 | $4,250.00 | $10,398.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,024.43 / $1,140.34 / $1,668.64
| Professional | | $1,024.43 | $1,140.34 | $1,668.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,141.13 / $1,184.19 / $1,184.19
| Professional | | $1,141.13 | $1,184.19 | $1,184.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,294.18 / $1,294.18 / $1,294.18
| Facility | | $1,294.18 | $1,294.18 | $1,294.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,077.88 / $1,397.26 / $2,294.27
| Professional | | $1,077.88 | $1,397.26 | $2,294.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,345.04 / $1,824.10 / $2,323.23
| Professional | | $1,345.04 | $1,824.10 | $2,323.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,719.66 / $15,719.66 / $15,719.66
| Facility | | $15,719.66 | $15,719.66 | $15,719.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,130.36 / $1,130.36 / $1,158.72
| Professional | | $1,130.36 | $1,130.36 | $1,158.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,426.00 / $5,511.00 / $11,083.00
| Facility | | $1,426.00 | $5,511.00 | $11,083.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,024.43 / $1,276.41 / $5,602.02
| Professional | | $1,024.43 | $1,276.41 | $5,602.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,438.00 / $1,438.00 / $2,328.40
| Professional | | $1,438.00 | $1,438.00 | $2,328.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,294.18 / $1,294.18 / $1,294.18
| Facility | | $1,294.18 | $1,294.18 | $1,294.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,077.88 / $1,415.62 / $2,375.78
| Professional | | $1,077.88 | $1,415.62 | $2,375.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,114.40 / $1,114.40 / $1,258.35
| Facility | | $1,114.40 | $1,114.40 | $1,258.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,077.99 / $1,122.11 / $1,258.35
| Professional | | $1,077.99 | $1,122.11 | $1,258.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $6,885.00 / $22,992.86
| Facility | | $2,468.00 | $6,885.00 | $22,992.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,076.52 / $1,402.53 / $2,176.48
| Professional | | $1,076.52 | $1,402.53 | $2,176.48 |