- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,839.00 / $8,247.00
| Facility | | $1,013.00 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $913.97 / $1,026.84 / $1,309.77
| Professional | | $913.97 | $1,026.84 | $1,309.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $908.85 / $1,447.54 / $1,938.89
| Professional | | $908.85 | $1,447.54 | $1,938.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $993.83 / $1,330.49 / $2,094.08
| Professional | | $993.83 | $1,330.49 | $2,094.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,198.50 / $1,585.51 / $1,590.52
| Professional | | $1,198.50 | $1,585.51 | $1,590.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $913.97 / $1,093.21 / $2,843.00
| Professional | | $913.97 | $1,093.21 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $1,311.00 / $2,553.30
| Professional | | $7.00 | $1,311.00 | $2,553.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,002.86 / $1,343.16 / $2,131.85
| Professional | | $1,002.86 | $1,343.16 | $2,131.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,001.50 / $1,001.50 / $1,210.41
| Facility | | $1,001.50 | $1,001.50 | $1,210.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $970.73 / $1,006.84 / $1,210.41
| Professional | | $970.73 | $1,006.84 | $1,210.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,015.39 / $1,360.84 / $2,182.81
| Professional | | $1,015.39 | $1,360.84 | $2,182.81 |