- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.21 / $2,747.00 / $4,806.64
| Facility | | $1,130.21 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,019.02 / $1,179.46 / $1,730.54
| Professional | | $1,019.02 | $1,179.46 | $1,730.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,733.00 / $10,656.56
| Facility | | $55.00 | $2,733.00 | $10,656.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,103.18 / $2,239.36 / $8,342.64
| Professional | | $1,103.18 | $2,239.36 | $8,342.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,500.95 / $2,225.51 / $3,014.80
| Professional | | $1,500.95 | $2,225.51 | $3,014.80 |
- 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
- $878.93 / $1,937.97 / $4,078.59
| Professional | | $878.93 | $1,937.97 | $4,078.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $1,855.91 / $6,679.00
| Facility | | $300.00 | $1,855.91 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,325.27 / $1,674.63 / $2,459.98
| Professional | | $1,325.27 | $1,674.63 | $2,459.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,460.63 / $2,859.91 / $3,534.33
| Professional | | $1,460.63 | $2,859.91 | $3,534.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,446.00 / $10,656.56
| Facility | | $55.00 | $2,446.00 | $10,656.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,240.76 / $2,325.77 / $8,342.64
| Professional | | $1,240.76 | $2,325.77 | $8,342.64 |
- 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
- $1,151.00 / $1,729.76 / $3,726.52
| Professional | | $1,151.00 | $1,729.76 | $3,726.52 |