- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,884.03 / $5,128.61
| Facility | | $1,513.56 | $2,884.03 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $724.44 / $1,737.80
| Professional | | $588.84 | $724.44 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $5,248.07 / $28,840.32
| Facility | | $1,174.90 | $5,248.07 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,000.00 / $4,786.30
| Professional | | $630.96 | $1,000.00 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $2,187.76 / $2,187.76
| Professional | | $602.56 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $645.65 / $3,715.35
| Facility | | $588.84 | $645.65 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $891.25 / $1,778.28
| Professional | | $467.74 | $891.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,380.38 / $7,079.46
| Facility | | $501.19 | $1,380.38 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $933.25 / $1,318.26
| Professional | | $676.08 | $933.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,570.88 / $11,220.18
| Facility | | $645.65 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $1,174.90 / $1,862.09
| Professional | | $660.69 | $1,174.90 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $5,248.07 / $28,840.32
| Facility | | $1,174.90 | $5,248.07 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,000.00 / $4,786.30
| Professional | | $630.96 | $1,000.00 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $4,786.30 / $10,232.93
| Facility | | $1,479.11 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $954.99 / $1,949.84
| Professional | | $630.96 | $954.99 | $1,949.84 |