- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $10,471.29 / $22,908.68
| Facility | | $4,265.80 | $10,471.29 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $851.14 / $3,801.89
| Professional | | $660.69 | $851.14 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,128.31 / $15,848.93
| Facility | | $4,570.88 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $1,122.02 / $2,290.87
| Professional | | $812.83 | $1,122.02 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $100.00 / $6,456.54
| Facility | | $63.10 | $100.00 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,071.52 / $2,089.30
| Professional | | $724.44 | $1,071.52 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $891.25 / $1,905.46
| Professional | | $691.83 | $891.25 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $724.44 / $870.96
| Professional | | $549.54 | $724.44 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $794.33 / $1,479.11
| Professional | | $602.56 | $794.33 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $5,623.41
| Facility | | $54.95 | $56.23 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,623.41 / $5,888.44 / $5,888.44
| Professional | | $5,623.41 | $5,888.44 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,000.00
| Professional | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $954.99 / $1,548.82
| Facility | | $741.31 | $954.99 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $891.25 / $1,905.46
| Professional | | $676.08 | $891.25 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Professional | | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $812.83 / $1,174.90
| Professional | | $588.84 | $812.83 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $6,165.95 / $18,620.87
| Facility | | $1,995.26 | $6,165.95 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $851.14 / $2,041.74
| Professional | | $588.84 | $851.14 | $2,041.74 |