- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,932.34 / $2,747.00 / $7,920.26
| Facility | | $1,932.34 | $2,747.00 | $7,920.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $890.40 / $1,431.82 / $5,064.31
| Professional | | $890.40 | $1,431.82 | $5,064.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,346.54 / $2,144.92 / $2,892.12
| Professional | | $1,346.54 | $2,144.92 | $2,892.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,538.70 / $2,193.51 / $2,469.67
| Professional | | $1,538.70 | $2,193.51 | $2,469.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.88 / $2,070.17 / $3,078.41
| Facility | | $1,387.88 | $2,070.17 | $3,078.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,515.21 / $1,735.97 / $3,136.20
| Professional | | $1,515.21 | $1,735.97 | $3,136.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,382.28 / $1,874.43 / $1,970.47
| Facility | | $1,382.28 | $1,874.43 | $1,970.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,431.82 / $2,232.92 / $2,763.84
| Facility | | $1,431.82 | $2,232.92 | $2,763.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,715.92 / $2,302.32 / $2,905.52
| Professional | | $1,715.92 | $2,302.32 | $2,905.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,135.52 / $5,135.52 / $5,135.52
| Facility | | $5,135.52 | $5,135.52 | $5,135.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,796.51 / $2,413.09 / $3,085.11
| Professional | | $1,796.51 | $2,413.09 | $3,085.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,364.00 / $7,664.00 / $36,803.00
| Facility | | $2,364.00 | $7,664.00 | $36,803.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,515.27 / $2,200.94 / $3,078.75
| Professional | | $1,515.27 | $2,200.94 | $3,078.75 |