- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,264.00 / $8,933.00
| Facility | | $1,013.00 | $4,264.00 | $8,933.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.52 / $1,684.72 / $2,395.60
| Professional | | $330.52 | $1,684.72 | $2,395.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,850.00 / $16,455.00 / $36,032.05
| Facility | | $8,850.00 | $16,455.00 | $36,032.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,461.20 / $2,691.60 / $3,166.59
| Professional | | $1,461.20 | $2,691.60 | $3,166.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $384.58 / $816.00 / $3,046.98
| Professional | | $384.58 | $816.00 | $3,046.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,698.16 / $2,698.16 / $2,787.38
| Professional | | $2,698.16 | $2,698.16 | $2,787.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,555.66 / $11,555.66 / $15,484.57
| Facility | | $11,555.66 | $11,555.66 | $15,484.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.00 / $5,350.00 / $10,247.00
| Facility | | $1,054.00 | $5,350.00 | $10,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.52 / $1,643.84 / $3,022.53
| Professional | | $330.52 | $1,643.84 | $3,022.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.87 / $727.74 / $3,125.56
| Professional | | $363.87 | $727.74 | $3,125.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.06 / $816.00 / $2,949.39
| Professional | | $392.06 | $816.00 | $2,949.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.29 / $385.08 / $1,869.07
| Facility | | $355.29 | $385.08 | $1,869.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.29 / $385.08 / $1,869.07
| Professional | | $355.29 | $385.08 | $1,869.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,584.00 / $9,631.00
| Facility | | $2,304.00 | $4,584.00 | $9,631.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,754.61 / $2,169.07 / $3,690.69
| Professional | | $1,754.61 | $2,169.07 | $3,690.69 |