- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,499.00 / $6,012.00 / $12,181.00
| Facility | | $1,499.00 | $6,012.00 | $12,181.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,254.56 / $1,509.52 / $2,832.60
| Professional | | $1,254.56 | $1,509.52 | $2,832.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,124.81 / $2,129.14 / $2,538.34
| Professional | | $1,124.81 | $2,129.14 | $2,538.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,314.02 / $1,730.25 / $2,722.05
| Professional | | $1,314.02 | $1,730.25 | $2,722.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,944.67 / $1,944.67 / $1,982.61
| Professional | | $1,944.67 | $1,944.67 | $1,982.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,011.01 / $37,011.01 / $37,011.01
| Facility | | $37,011.01 | $37,011.01 | $37,011.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $7,175.00 / $12,227.00
| Facility | | $1,301.00 | $7,175.00 | $12,227.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,368.52 / $1,607.72 / $6,934.90
| Professional | | $1,368.52 | $1,607.72 | $6,934.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $15.00 / $3,312.70
| Professional | | $15.00 | $15.00 | $3,312.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,362.26 / $1,730.25 / $2,747.21
| Professional | | $1,362.26 | $1,730.25 | $2,747.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,299.83 / $1,299.83 / $1,454.95
| Facility | | $1,299.83 | $1,299.83 | $1,454.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,242.92 / $1,323.49 / $1,454.95
| Professional | | $1,242.92 | $1,323.49 | $1,454.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.00 / $2,391.00 / $6,322.00
| Facility | | $656.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,291.30 / $1,743.14 / $2,791.11
| Professional | | $1,291.30 | $1,743.14 | $2,791.11 |