- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,219.32 / $2,671.00 / $4,806.64
| Facility | | $1,219.32 | $2,671.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,113.25 / $1,278.04 / $1,896.59
| Professional | | $1,113.25 | $1,278.04 | $1,896.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.21 / $4,287.00 / $17,314.56
| Facility | | $941.21 | $4,287.00 | $17,314.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,333.64 / $2,396.84 / $9,854.73
| Professional | | $1,333.64 | $2,396.84 | $9,854.73 |
- 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
- $1,097.03 / $2,109.21 / $4,418.62
| Professional | | $1,097.03 | $2,109.21 | $4,418.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,009.30 / $6,679.00
| Facility | | $814.00 | $2,009.30 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,435.24 / $1,813.59 / $2,664.10
| Professional | | $1,435.24 | $1,813.59 | $2,664.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,582.28 / $3,098.10 / $3,828.28
| Professional | | $1,582.28 | $3,098.10 | $3,828.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $6,104.00 / $17,314.56
| Facility | | $1,485.00 | $6,104.00 | $17,314.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,381.86 / $2,521.56 / $9,854.73
| Professional | | $1,381.86 | $2,521.56 | $9,854.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $4,287.00 / $7,608.00
| Facility | | $1,485.00 | $4,287.00 | $7,608.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,352.37 / $1,894.94 / $4,137.82
| Professional | | $1,352.37 | $1,894.94 | $4,137.82 |