- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,048.00 / $8,451.00
| Facility | | $1,020.00 | $4,048.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $861.90 / $981.90 / $1,514.37
| Professional | | $861.90 | $981.90 | $1,514.37 |
- 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
- $963.69 / $1,030.06 / $1,747.53
| Professional | | $963.69 | $1,030.06 | $1,747.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.54 / $1,089.54 / $1,089.54
| Facility | | $1,089.54 | $1,089.54 | $1,089.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $928.18 / $1,203.75 / $1,936.47
| Professional | | $928.18 | $1,203.75 | $1,936.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,140.05 / $1,544.78 / $1,969.18
| Professional | | $1,140.05 | $1,544.78 | $1,969.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,100.92 / $42,100.92 / $42,100.92
| Facility | | $42,100.92 | $42,100.92 | $42,100.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,151.00 / $5,342.00 / $10,247.00
| Facility | | $1,151.00 | $5,342.00 | $10,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $871.67 / $1,122.09 / $4,742.43
| Professional | | $871.67 | $1,122.09 | $4,742.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,265.59 / $1,271.79 / $1,962.80
| Professional | | $1,265.59 | $1,271.79 | $1,962.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.54 / $1,089.54 / $1,089.54
| Facility | | $1,089.54 | $1,089.54 | $1,089.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $928.18 / $1,208.56 / $1,981.83
| Professional | | $928.18 | $1,208.56 | $1,981.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.68 / $937.68 / $937.68
| Facility | | $937.68 | $937.68 | $937.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $908.60 / $942.53 / $994.38
| Professional | | $908.60 | $942.53 | $994.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $9,631.00
| Facility | | $2,468.00 | $4,563.00 | $9,631.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $936.76 / $1,157.02 / $1,879.11
| Professional | | $936.76 | $1,157.02 | $1,879.11 |