- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,116.95 / $3,066.00 / $7,799.00
| Facility | | $1,116.95 | $3,066.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $963.34 / $1,046.02 / $1,478.98
| Professional | | $963.34 | $1,046.02 | $1,478.98 |
- 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
- $1,062.40 / $1,102.49 / $1,821.34
| Professional | | $1,062.40 | $1,102.49 | $1,821.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,203.36 / $1,203.36 / $1,203.36
| Facility | | $1,203.36 | $1,203.36 | $1,203.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $927.48 / $1,263.90 / $2,126.16
| Professional | | $927.48 | $1,263.90 | $2,126.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,259.98 / $1,706.22 / $2,176.34
| Professional | | $1,259.98 | $1,706.22 | $2,176.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,401.41 / $19,401.41 / $19,401.41
| Facility | | $19,401.41 | $19,401.41 | $19,401.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,839.00 / $8,017.00
| Facility | | $1,013.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $963.34 / $1,117.26 / $5,330.84
| Professional | | $963.34 | $1,117.26 | $5,330.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,334.40 / $1,334.40 / $2,201.40
| Professional | | $1,334.40 | $1,334.40 | $2,201.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,203.36 / $1,203.36 / $1,203.36
| Facility | | $1,203.36 | $1,203.36 | $1,203.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $934.37 / $1,287.53 / $2,132.34
| Professional | | $934.37 | $1,287.53 | $2,132.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,042.91 / $1,042.91 / $1,105.09
| Facility | | $1,042.91 | $1,042.91 | $1,105.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,012.31 / $1,046.50 / $1,108.54
| Professional | | $1,012.31 | $1,046.50 | $1,108.54 |
- 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
- $923.11 / $1,239.03 / $1,936.36
| Professional | | $923.11 | $1,239.03 | $1,936.36 |