- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,715.35 / $12,882.50
| Facility | | $1,000.00 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $831.76 / $1,288.25
| Professional | | $691.83 | $831.76 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,677.35 / $9,120.11
| Facility | | $2,691.53 | $4,677.35 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $933.25 / $1,230.27
| Professional | | $724.44 | $933.25 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $758.58 / $758.58
| Facility | | $79.43 | $758.58 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $1,023.29 / $1,584.89
| Professional | | $741.31 | $1,023.29 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $8,912.51
| Facility | | $54.95 | $56.23 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,754.40 / $6,760.83 / $6,760.83
| Professional | | $5,754.40 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,000.00 / $3,235.94
| Facility | | $758.58 | $1,000.00 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $1,023.29 / $1,412.54
| Professional | | $707.95 | $1,023.29 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $741.31
| Professional | | $32.36 | $33.11 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $954.99 / $1,479.11
| Professional | | $954.99 | $954.99 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $977.24 / $1,621.81
| Facility | | $776.25 | $977.24 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $1,023.29 / $1,621.81
| Professional | | $707.95 | $1,023.29 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,709.64
| Facility | | $1,380.38 | $4,073.80 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $794.33 / $1,230.27
| Professional | | $588.84 | $794.33 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $794.33 / $794.33
| Professional | | $758.58 | $794.33 | $794.33 |