- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.46 / $4,761.00 / $8,451.00
| Facility | | $1,093.46 | $4,761.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $798.89 / $1,024.71 / $1,327.63
| Professional | | $798.89 | $1,024.71 | $1,327.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $983.45 / $1,020.56 / $1,020.56
| Professional | | $983.45 | $1,020.56 | $1,020.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $896.84 / $1,222.47 / $2,029.79
| Professional | | $896.84 | $1,222.47 | $2,029.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,177.51 / $1,562.19 / $1,580.78
| Professional | | $1,177.51 | $1,562.19 | $1,580.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.46 / $5,342.00 / $9,617.00
| Facility | | $1,093.46 | $5,342.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $798.89 / $1,059.34 / $5,120.72
| Professional | | $798.89 | $1,059.34 | $5,120.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $990.50 / $2,657.70
| Professional | | $5.00 | $990.50 | $2,657.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $907.11 / $1,231.00 / $2,044.29
| Professional | | $907.11 | $1,231.00 | $2,044.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $958.30 / $986.65 / $986.65
| Facility | | $958.30 | $986.65 | $986.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $958.30 / $986.65 / $1,052.09
| Professional | | $958.30 | $986.65 | $1,052.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $810.13 / $1,149.96 / $1,915.90
| Professional | | $810.13 | $1,149.96 | $1,915.90 |