- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,557.00 / $4,206.16 / $9,608.04
| Facility | | $1,557.00 | $4,206.16 | $9,608.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $682.71 / $838.47 / $1,643.40
| Professional | | $682.71 | $838.47 | $1,643.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,823.00 / $12,004.00 / $15,528.00
| Facility | | $9,823.00 | $12,004.00 | $15,528.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $730.48 / $945.17 / $1,562.64
| Professional | | $730.48 | $945.17 | $1,562.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $814.35 / $906.48 / $5,113.00
| Professional | | $814.35 | $906.48 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.00 / $572.00 / $898.71
| Facility | | $572.00 | $572.00 | $898.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $762.20 / $968.90 / $1,689.80
| Professional | | $762.20 | $968.90 | $1,689.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $759.94 / $976.06 / $1,153.53
| Professional | | $759.94 | $976.06 | $1,153.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.45 / $988.14 / $1,479.17
| Facility | | $787.45 | $988.14 | $1,479.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $926.00 / $1,063.00 / $1,479.00
| Professional | | $926.00 | $1,063.00 | $1,479.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $743.20 / $966.29 / $3,254.16
| Facility | | $743.20 | $966.29 | $3,254.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $743.20 / $966.29 / $3,254.16
| Professional | | $743.20 | $966.29 | $3,254.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,651.00 / $6,870.00 / $12,739.00
| Facility | | $3,651.00 | $6,870.00 | $12,739.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.15 / $917.64 / $1,426.92
| Professional | | $588.15 | $917.64 | $1,426.92 |