- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,715.35 / $11,748.98
| Facility | | $1,000.00 | $3,715.35 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $602.56 / $1,023.29
| Professional | | $501.19 | $602.56 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $676.08 / $933.25
| Professional | | $537.03 | $676.08 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $537.03 / $537.03
| Facility | | $79.43 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $758.58 / $1,202.26
| Professional | | $549.54 | $758.58 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $45,708.82 / $45,708.82
| Facility | | $4,786.30 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,011.87 / $5,011.87
| Professional | | $4,168.69 | $5,011.87 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $831.76 / $5,248.07
| Facility | | $562.34 | $831.76 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $724.44 / $1,000.00
| Professional | | $512.86 | $724.44 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $537.03
| Professional | | $32.36 | $33.11 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $1,071.52
| Professional | | $630.96 | $630.96 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $724.44 / $1,230.27
| Facility | | $549.54 | $724.44 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $758.58 / $1,202.26
| Professional | | $524.81 | $758.58 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,128.61 / $10,964.78
| Facility | | $1,698.24 | $5,128.61 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $602.56 / $912.01
| Professional | | $457.09 | $602.56 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $575.44 / $575.44
| Professional | | $537.03 | $575.44 | $575.44 |