- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,004.78 / $4,761.00 / $8,451.00
| Facility | | $1,004.78 | $4,761.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $763.72 / $932.36 / $1,204.92
| Professional | | $763.72 | $932.36 | $1,204.92 |
- 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
- $910.49 / $944.85 / $944.85
| Professional | | $910.49 | $944.85 | $944.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $848.36 / $1,154.92 / $1,876.43
| Professional | | $848.36 | $1,154.92 | $1,876.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,102.25 / $1,462.56 / $1,493.49
| Professional | | $1,102.25 | $1,462.56 | $1,493.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.00 / $5,342.00 / $9,617.00
| Facility | | $1,054.00 | $5,342.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $772.25 / $955.69 / $4,674.68
| Professional | | $772.25 | $955.69 | $4,674.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $846.10 / $2,471.69
| Professional | | $6.00 | $846.10 | $2,471.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $858.95 / $1,156.75 / $1,892.69
| Professional | | $858.95 | $1,156.75 | $1,892.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.93 / $900.16 / $900.16
| Facility | | $708.93 | $900.16 | $900.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $708.93 / $900.16 / $967.92
| Professional | | $708.93 | $900.16 | $967.92 |
- 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
- $748.42 / $1,070.64 / $1,726.17
| Professional | | $748.42 | $1,070.64 | $1,726.17 |