- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,630.78 / $5,623.41
| Facility | | $1,949.84 | $3,630.78 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $602.56 / $1,862.09
| Professional | | $338.84 | $602.56 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $5,495.41 / $33,884.42
| Facility | | $1,148.15 | $5,495.41 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $691.83 / $7,413.10
| Professional | | $371.54 | $691.83 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,000.00 / $1,778.28
| Professional | | $630.96 | $1,000.00 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $1,023.29 / $7,079.46
| Facility | | $478.63 | $1,023.29 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $676.08 / $1,023.29
| Professional | | $562.34 | $676.08 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $870.96 / $1,513.56
| Professional | | $489.78 | $870.96 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $5,495.41 / $33,884.42
| Facility | | $1,148.15 | $5,495.41 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $691.83 / $7,413.10
| Professional | | $371.54 | $691.83 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $10,471.29
| Facility | | $2,041.74 | $5,248.07 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $758.58 / $2,041.74
| Professional | | $549.54 | $758.58 | $2,041.74 |