- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $3,090.30 / $9,120.11
| Facility | | $446.68 | $3,090.30 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $562.34 / $1,995.26
| Professional | | $398.11 | $562.34 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $1,000.00 / $2,398.83
| Professional | | $512.86 | $1,000.00 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,584.89 / $2,570.40
| Facility | | $1,380.38 | $1,584.89 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $1,288.25 / $1,862.09
| Professional | | $676.08 | $1,288.25 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,047.13 / $4,168.69
| Facility | | $446.68 | $1,047.13 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,122.02 / $1,513.56
| Professional | | $870.96 | $1,122.02 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,318.26 / $8,317.64
| Facility | | $446.68 | $1,318.26 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $912.01 / $3,890.45
| Professional | | $549.54 | $912.01 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $676.08
| Professional | | $32.36 | $33.11 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $1,258.93 / $1,905.46
| Professional | | $616.60 | $1,258.93 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,709.64 / $8,709.64
| Facility | | $5,888.44 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $1,412.54 / $3,801.89
| Professional | | $426.58 | $1,412.54 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,290.87 / $3,388.44
| Professional | | $1,584.89 | $2,290.87 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $758.58 / $1,862.09
| Professional | | $436.52 | $758.58 | $1,862.09 |