- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,044.25 / $2,747.00 / $7,263.00
| Facility | | $1,044.25 | $2,747.00 | $7,263.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $896.21 / $967.52 / $1,616.99
| Professional | | $896.21 | $967.52 | $1,616.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $973.53 / $1,010.26 / $1,010.26
| Professional | | $973.53 | $1,010.26 | $1,010.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,111.38 / $1,111.38 / $1,111.38
| Facility | | $1,111.38 | $1,111.38 | $1,111.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $860.42 / $1,158.45 / $1,973.55
| Professional | | $860.42 | $1,158.45 | $1,973.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,160.60 / $1,569.14 / $2,004.69
| Professional | | $1,160.60 | $1,569.14 | $2,004.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,872.50 / $8,746.77 / $13,112.83
| Facility | | $1,872.50 | $8,746.77 | $13,112.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $3,838.00 / $8,017.00
| Facility | | $1,020.00 | $3,838.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $896.21 / $1,044.25 / $3,494.00
| Professional | | $896.21 | $1,044.25 | $3,494.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,078.00 / $1,078.00 / $2,069.80
| Professional | | $1,078.00 | $1,078.00 | $2,069.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,111.38 / $1,111.38 / $1,111.38
| Facility | | $1,111.38 | $1,111.38 | $1,111.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $866.36 / $1,181.81 / $2,008.96
| Professional | | $866.36 | $1,181.81 | $2,008.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $965.95 / $965.95 / $1,067.20
| Facility | | $965.95 | $965.95 | $1,067.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $940.54 / $966.21 / $1,067.20
| Professional | | $940.54 | $966.21 | $1,067.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $845.13 / $1,165.30 / $1,795.33
| Professional | | $845.13 | $1,165.30 | $1,795.33 |