- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,084.00 / $3,748.00 / $8,017.00
| Facility | | $1,084.00 | $3,748.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $982.16 / $1,083.77 / $1,676.70
| Professional | | $982.16 | $1,083.77 | $1,676.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $860.49 / $1,012.34 / $1,656.13
| Professional | | $860.49 | $1,012.34 | $1,656.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $946.99 / $1,275.80 / $2,311.17
| Professional | | $946.99 | $1,275.80 | $2,311.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,488.91 / $1,488.91 / $1,506.55
| Professional | | $1,488.91 | $1,488.91 | $1,506.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,168.05 / $1,168.05 / $1,168.05
| Professional | | $1,168.05 | $1,168.05 | $1,168.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,964.00 / $8,017.00
| Facility | | $1,013.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $982.16 / $1,157.65 / $3,748.00
| Professional | | $982.16 | $1,157.65 | $3,748.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.00 / $1,778.20 / $2,432.40
| Professional | | $8.00 | $1,778.20 | $2,432.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $966.32 / $1,340.14 / $2,492.01
| Professional | | $966.32 | $1,340.14 | $2,492.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.70 / $1,123.70 / $1,123.70
| Facility | | $1,123.70 | $1,123.70 | $1,123.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,123.70 / $1,123.70 / $1,123.70
| Professional | | $1,123.70 | $1,123.70 | $1,123.70 |
- 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
- $956.59 / $1,256.43 / $1,970.49
| Professional | | $956.59 | $1,256.43 | $1,970.49 |