- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,029.27 / $4,028.00 / $13,401.00
| Facility | | $1,029.27 | $4,028.00 | $13,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $914.54 / $1,031.11 / $1,604.50
| Professional | | $914.54 | $1,031.11 | $1,604.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,149.00 / $7,518.32 / $14,454.58
| Facility | | $4,149.00 | $7,518.32 | $14,454.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $792.65 / $1,001.96 / $1,636.00
| Professional | | $792.65 | $1,001.96 | $1,636.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $889.03 / $889.03 / $903.03
| Facility | | $889.03 | $889.03 | $903.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $966.74 / $1,250.67 / $1,807.39
| Professional | | $966.74 | $1,250.67 | $1,807.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $26,542.00 / $26,542.00
| Facility | | $11,500.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,614.87 / $9,966.91 / $9,966.91
| Professional | | $8,614.87 | $9,966.91 | $9,966.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $946.15 / $1,107.13 / $1,574.42
| Facility | | $946.15 | $1,107.13 | $1,574.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $989.48 / $1,583.17 / $1,978.96
| Professional | | $989.48 | $1,583.17 | $1,978.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $946.15 / $1,145.41 / $1,646.46
| Facility | | $946.15 | $1,145.41 | $1,646.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $985.77 / $1,307.64 / $1,981.61
| Professional | | $985.77 | $1,307.64 | $1,981.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $13,237.00
| Facility | | $2,093.00 | $6,000.00 | $13,237.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $786.02 / $1,054.90 / $1,546.13
| Professional | | $786.02 | $1,054.90 | $1,546.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $844.49 / $959.34 / $1,332.87
| Professional | | $844.49 | $959.34 | $1,332.87 |