- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,352.41 / $4,534.00 / $8,404.00
| Facility | | $1,352.41 | $4,534.00 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $876.45 / $1,253.46 / $1,612.70
| Professional | | $876.45 | $1,253.46 | $1,612.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,800.00 / $11,479.00 / $17,952.00
| Facility | | $5,800.00 | $11,479.00 | $17,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,197.33 / $1,242.53 / $1,242.53
| Professional | | $1,197.33 | $1,242.53 | $1,242.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $974.93 / $1,395.13 / $2,282.76
| Professional | | $974.93 | $1,395.13 | $2,282.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,453.84 / $1,932.58 / $1,955.96
| Professional | | $1,453.84 | $1,932.58 | $1,955.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,530.54 / $12,075.02 / $66,670.58
| Facility | | $9,530.54 | $12,075.02 | $66,670.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,831.00 / $8,404.00
| Facility | | $1,020.00 | $4,831.00 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $960.28 / $1,352.41 / $4,831.00
| Professional | | $960.28 | $1,352.41 | $4,831.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $924.10 / $3,310.80
| Professional | | $5.00 | $924.10 | $3,310.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.32 / $1,453.86 / $2,302.78
| Professional | | $1,023.32 | $1,453.86 | $2,302.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,016.96 / $1,201.54 / $1,201.54
| Facility | | $1,016.96 | $1,201.54 | $1,201.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,016.96 / $1,201.54 / $1,291.20
| Professional | | $1,016.96 | $1,201.54 | $1,291.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $955.53 / $1,329.36 / $2,344.59
| Professional | | $955.53 | $1,329.36 | $2,344.59 |