- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,197.85 / $7,858.00 / $18,681.00
| Facility | | $2,197.85 | $7,858.00 | $18,681.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $877.72 / $1,076.78 / $5,761.41
| Professional | | $877.72 | $1,076.78 | $5,761.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,629.00 / $7,166.00 / $15,328.00
| Facility | | $2,629.00 | $7,166.00 | $15,328.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,261.90 / $1,653.95 / $3,179.98
| Professional | | $1,261.90 | $1,653.95 | $3,179.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $10,419.62
| Facility | | $66.00 | $100.00 | $10,419.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $768.59 / $1,208.44 / $2,940.36
| Professional | | $768.59 | $1,208.44 | $2,940.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,233.39 / $6,184.91 / $14,571.12
| Facility | | $5,233.39 | $6,184.91 | $14,571.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,019.95 / $1,403.65 / $3,951.74
| Professional | | $1,019.95 | $1,403.65 | $3,951.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $817.94 / $1,323.11 / $1,786.20
| Professional | | $817.94 | $1,323.11 | $1,786.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,139.73 / $1,481.65 / $2,628.08
| Professional | | $1,139.73 | $1,481.65 | $2,628.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,184.62 / $23,497.10 / $26,542.00
| Facility | | $6,184.62 | $23,497.10 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,090.00 / $8,358.56 / $9,422.10
| Professional | | $8,090.00 | $8,358.56 | $9,422.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,166.43 / $1,451.28 / $2,116.98
| Facility | | $1,166.43 | $1,451.28 | $2,116.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,051.79 / $1,481.68 / $3,192.14
| Professional | | $1,051.79 | $1,481.68 | $3,192.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,574.85 / $3,574.85 / $3,574.85
| Professional | | $3,574.85 | $3,574.85 | $3,574.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $817.94 / $1,226.91 / $1,547.24
| Professional | | $817.94 | $1,226.91 | $1,547.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,799.00 / $12,377.00 / $26,672.00
| Facility | | $5,799.00 | $12,377.00 | $26,672.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $875.28 / $1,312.92 / $3,999.29
| Professional | | $875.28 | $1,312.92 | $3,999.29 |