- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,198.00 / $4,400.00 / $17,392.00
| Facility | | $1,198.00 | $4,400.00 | $17,392.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,278.64 / $1,466.76 / $1,798.25
| Professional | | $1,278.64 | $1,466.76 | $1,798.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,344.02 / $2,318.98 / $7,901.00
| Facility | | $1,344.02 | $2,318.98 | $7,901.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,215.19 / $1,533.40 / $2,095.98
| Professional | | $1,215.19 | $1,533.40 | $2,095.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,109.06 / $1,109.06 / $1,109.06
| Facility | | $1,109.06 | $1,109.06 | $1,109.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,330.45 / $1,780.01 / $2,774.28
| Professional | | $1,330.45 | $1,780.01 | $2,774.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $23,029.44
| Facility | | $55.00 | $55.00 | $23,029.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,155.68 / $9,436.32 / $10,658.48
| Professional | | $9,155.68 | $9,436.32 | $10,658.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,229.93 / $1,511.02 / $3,034.72
| Facility | | $1,229.93 | $1,511.02 | $3,034.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,604.64 / $1,851.51 / $2,160.10
| Professional | | $1,604.64 | $1,851.51 | $2,160.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,229.93 / $1,511.88 / $3,386.92
| Facility | | $1,229.93 | $1,511.88 | $3,386.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,299.59 / $1,830.37 / $2,982.13
| Professional | | $1,299.59 | $1,830.37 | $2,982.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,073.59 / $1,493.78 / $2,287.96
| Professional | | $1,073.59 | $1,493.78 | $2,287.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,053.47 / $1,209.50 / $1,659.64
| Professional | | $1,053.47 | $1,209.50 | $1,659.64 |