- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $581.74 / $581.74 / $3,087.62
| Professional | | $581.74 | $581.74 | $3,087.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,522.03 / $5,947.70 / $11,504.78
| Facility | | $4,522.03 | $5,947.70 | $11,504.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $564.12 / $961.57 / $1,282.08
| Professional | | $564.12 | $961.57 | $1,282.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $907.00 / $1,405.89 / $1,884.80
| Professional | | $907.00 | $1,405.89 | $1,884.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.74 / $1,018.05 / $5,405.32
| Facility | | $581.74 | $1,018.05 | $5,405.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $769.00 / $1,271.81 / $1,747.00
| Professional | | $769.00 | $1,271.81 | $1,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,460.89 / $2,961.89
| Facility | | $1,089.00 | $1,460.89 | $2,961.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,055.00 / $1,289.50 / $1,884.80
| Professional | | $1,055.00 | $1,289.50 | $1,884.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $640.66 / $1,162.10 / $3,257.00
| Professional | | $640.66 | $1,162.10 | $3,257.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $769.00 / $1,298.00 / $1,656.31
| Professional | | $769.00 | $1,298.00 | $1,656.31 |