- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,250.00 / $2,671.00 / $4,712.00
| Facility | | $1,250.00 | $2,671.00 | $4,712.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.49 / $1,115.58 / $2,989.42
| Professional | | $307.49 | $1,115.58 | $2,989.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.20 / $5,268.00 / $26,542.00
| Facility | | $646.20 | $5,268.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.39 / $1,642.23 / $9,157.00
| Professional | | $286.39 | $1,642.23 | $9,157.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.75 / $398.78 / $782.21
| Facility | | $306.75 | $398.78 | $782.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $433.28 / $1,157.40 / $2,077.42
| Professional | | $433.28 | $1,157.40 | $2,077.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.73 / $1,427.62 / $3,519.92
| Professional | | $473.73 | $1,427.62 | $3,519.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.30 / $559.32 / $6,679.00
| Facility | | $269.30 | $559.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,166.00 / $1,379.59 / $2,466.61
| Professional | | $1,166.00 | $1,379.59 | $2,466.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.05 / $1,155.48 / $2,877.84
| Professional | | $335.05 | $1,155.48 | $2,877.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,839.72 / $5,572.00 / $26,542.00
| Facility | | $1,839.72 | $5,572.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,515.90 / $3,309.74 / $11,536.43
| Professional | | $1,515.90 | $3,309.74 | $11,536.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,450.25 / $2,536.98 / $4,602.82
| Professional | | $1,450.25 | $2,536.98 | $4,602.82 |