- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,033.67 / $5,079.00 / $9,534.00
| Facility | | $1,033.67 | $5,079.00 | $9,534.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $860.10 / $1,025.17 / $1,186.20
| Professional | | $860.10 | $1,025.17 | $1,186.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $853.15 / $1,360.35 / $1,827.68
| Professional | | $853.15 | $1,360.35 | $1,827.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.76 / $1,250.25 / $1,974.29
| Professional | | $933.76 | $1,250.25 | $1,974.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,123.55 / $1,486.20 / $1,490.01
| Professional | | $1,123.55 | $1,486.20 | $1,490.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,298.00 / $5,350.00 / $9,830.00
| Facility | | $1,298.00 | $5,350.00 | $9,830.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $860.10 / $1,033.67 / $2,843.00
| Professional | | $860.10 | $1,033.67 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,165.40 / $2,397.19
| Professional | | $6.00 | $1,165.40 | $2,397.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $958.09 / $1,261.98 / $2,106.39
| Professional | | $958.09 | $1,261.98 | $2,106.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.18 / $941.18 / $1,080.86
| Facility | | $941.18 | $941.18 | $1,080.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $911.92 / $946.57 / $1,080.86
| Professional | | $911.92 | $946.57 | $1,080.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,563.00 / $8,261.00
| Facility | | $2,304.00 | $4,563.00 | $8,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $964.48 / $1,200.24 / $2,044.69
| Professional | | $964.48 | $1,200.24 | $2,044.69 |