- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $10,471.29 / $22,908.68
| Facility | | $4,466.84 | $10,471.29 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $10,471.29 / $17,782.79
| Facility | | $6,025.60 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $4,073.80 / $10,964.78
| Facility | | $66.07 | $4,073.80 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $741.31 / $1,000.00
| Professional | | $371.54 | $741.31 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $794.33 / $1,288.25
| Professional | | $616.60 | $794.33 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $9,332.54
| Facility | | $54.95 | $56.23 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $891.25 / $1,318.26
| Facility | | $660.69 | $891.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $10,000.00 / $20,892.96
| Facility | | $5,370.32 | $10,000.00 | $20,892.96 |