- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,890.45 / $12,882.50
| Facility | | $1,000.00 | $3,890.45 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,570.88 / $5,370.32 / $7,943.28
| Professional | | $4,570.88 | $5,370.32 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,466.84 / $5,370.32 / $6,165.95
| Professional | | $4,466.84 | $5,370.32 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $4,466.84 / $4,897.79
| Facility | | $4,466.84 | $4,466.84 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,511.89 / $8,317.64
| Facility | | $891.25 | $2,511.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,344.23 / $6,165.95 / $10,232.93
| Professional | | $2,344.23 | $6,165.95 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $87,096.36
| Facility | | $54.95 | $56.23 | $87,096.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33,884.42 / $41,686.94 / $41,686.94
| Professional | | $33,884.42 | $41,686.94 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $5,623.41 / $10,715.19
| Facility | | $2,754.23 | $5,623.41 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,570.88 / $5,370.32 / $7,943.28
| Professional | | $4,570.88 | $5,370.32 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $4,073.80
| Professional | | $32.36 | $33.11 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,630.27 / $9,549.93 / $12,022.64
| Professional | | $2,630.27 | $9,549.93 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $5,754.40 / $10,471.29
| Facility | | $3,019.95 | $5,754.40 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,165.95 / $11,220.18
| Professional | | $2,187.76 | $6,165.95 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $2,290.87 / $10,000.00
| Facility | | $407.38 | $2,290.87 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,981.07 / $5,370.32 / $8,128.31
| Professional | | $3,981.07 | $5,370.32 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,715.35 / $4,897.79 / $5,495.41
| Professional | | $3,715.35 | $4,897.79 | $5,495.41 |