- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,384.00 / $4,761.00 / $8,451.00
| Facility | | $1,384.00 | $4,761.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,284.81 / $1,509.20 / $1,972.94
| Professional | | $1,284.81 | $1,509.20 | $1,972.94 |
- 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
- $1,479.18 / $2,286.67 / $2,719.19
| Professional | | $1,479.18 | $2,286.67 | $2,719.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,432.34 / $1,935.81 / $3,010.81
| Professional | | $1,432.34 | $1,935.81 | $3,010.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,758.41 / $2,332.64 / $2,346.44
| Professional | | $1,758.41 | $2,332.64 | $2,346.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,680.16 / $2,680.16 / $2,680.16
| Facility | | $2,680.16 | $2,680.16 | $2,680.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,993.00 / $9,617.00
| Facility | | $1,020.00 | $4,993.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,284.81 / $1,538.79 / $5,958.00
| Professional | | $1,284.81 | $1,538.79 | $5,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $6.00 / $3,847.40
| Professional | | $6.00 | $6.00 | $3,847.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,470.73 / $1,936.49 / $3,365.11
| Professional | | $1,470.73 | $1,936.49 | $3,365.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,460.63 / $1,460.63 / $1,579.71
| Facility | | $1,460.63 | $1,460.63 | $1,579.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,422.67 / $1,460.88 / $1,579.71
| Professional | | $1,422.67 | $1,460.88 | $1,579.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $6,885.00 / $19,040.18
| Facility | | $2,468.00 | $6,885.00 | $19,040.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,300.58 / $1,814.09 / $2,904.09
| Professional | | $1,300.58 | $1,814.09 | $2,904.09 |