- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $3,839.00 / $8,247.00
| Facility | | $1,020.00 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,489.77 / $1,700.66 / $2,112.48
| Professional | | $1,489.77 | $1,700.66 | $2,112.48 |
- 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
- $1,521.42 / $1,578.83 / $1,578.83
| Professional | | $1,521.42 | $1,578.83 | $1,578.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,497.99 / $1,969.38 / $3,067.79
| Professional | | $1,497.99 | $1,969.38 | $3,067.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,327.03 / $2,327.03 / $2,429.85
| Professional | | $2,327.03 | $2,327.03 | $2,429.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,824.53 / $1,824.53 / $1,824.53
| Professional | | $1,824.53 | $1,824.53 | $1,824.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,426.00 / $1,828.04 / $5,958.00
| Professional | | $1,426.00 | $1,828.04 | $5,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $2,633.80 / $3,779.30
| Professional | | $15.00 | $2,633.80 | $3,779.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,535.55 / $1,992.46 / $3,067.79
| Professional | | $1,535.55 | $1,992.46 | $3,067.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.48 / $1,481.48 / $1,919.94
| Facility | | $1,481.48 | $1,481.48 | $1,919.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,418.73 / $1,506.58 / $1,919.94
| Professional | | $1,418.73 | $1,506.58 | $1,919.94 |
- 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
- $1,438.66 / $1,978.06 / $3,124.33
| Professional | | $1,438.66 | $1,978.06 | $3,124.33 |