- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,924.00 / $2,747.00 / $5,048.00
| Facility | | $1,924.00 | $2,747.00 | $5,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.39 / $613.54 / $1,512.79
| Professional | | $540.39 | $613.54 | $1,512.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,369.43 / $4,402.00 / $9,401.00
| Facility | | $1,369.43 | $4,402.00 | $9,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.13 / $1,033.22 / $6,307.00
| Professional | | $600.13 | $1,033.22 | $6,307.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $728.32 / $1,194.36 / $1,617.96
| Professional | | $728.32 | $1,194.36 | $1,617.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.96 / $1,000.70 / $1,722.61
| Professional | | $626.96 | $1,000.70 | $1,722.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.08 / $1,328.02 / $6,679.00
| Facility | | $612.08 | $1,328.02 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $702.36 / $850.79 / $1,168.66
| Professional | | $702.36 | $850.79 | $1,168.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,503.81 / $1,983.76
| Professional | | $758.58 | $1,503.81 | $1,983.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,801.23 / $5,801.23 / $5,801.23
| Facility | | $5,801.23 | $5,801.23 | $5,801.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $892.50 / $955.58 / $1,174.00
| Professional | | $892.50 | $955.58 | $1,174.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $5,268.00 / $26,542.00
| Facility | | $2,155.00 | $5,268.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $652.91 / $1,121.40 / $6,307.00
| Professional | | $652.91 | $1,121.40 | $6,307.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.82 / $911.28 / $1,790.21
| Professional | | $621.82 | $911.28 | $1,790.21 |