- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,254.33 / $2,747.00 / $4,806.64
| Facility | | $1,254.33 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,157.53 / $1,321.68 / $1,940.08
| Professional | | $1,157.53 | $1,321.68 | $1,940.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,825.00 / $23,291.36
| Facility | | $55.00 | $2,825.00 | $23,291.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,358.41 / $2,440.55 / $9,130.87
| Professional | | $1,358.41 | $2,440.55 | $9,130.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $680.00 / $748.00
| Facility | | $50.00 | $680.00 | $748.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,290.00 / $2,161.48 / $4,448.88
| Professional | | $1,290.00 | $2,161.48 | $4,448.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,019.38 / $6,679.00
| Facility | | $814.00 | $2,019.38 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,445.86 / $1,827.01 / $2,762.23
| Professional | | $1,445.86 | $1,827.01 | $2,762.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,595.80 / $3,124.58 / $3,866.15
| Professional | | $1,595.80 | $3,124.58 | $3,866.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,446.00 / $23,291.36
| Facility | | $55.00 | $2,446.00 | $23,291.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,456.30 / $2,544.17 / $9,130.87
| Professional | | $1,456.30 | $2,544.17 | $9,130.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $2,446.00 / $4,050.00
| Facility | | $789.00 | $2,446.00 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,365.08 / $1,966.01 / $4,368.89
| Professional | | $1,365.08 | $1,966.01 | $4,368.89 |