- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,156.07 / $5,254.00 / $10,398.00
| Facility | | $1,156.07 | $5,254.00 | $10,398.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $960.61 / $1,092.46 / $1,375.98
| Professional | | $960.61 | $1,092.46 | $1,375.98 |
- 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
- $1,082.81 / $1,123.67 / $1,123.67
| Professional | | $1,082.81 | $1,123.67 | $1,123.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,044.45 / $1,397.36 / $2,195.80
| Professional | | $1,044.45 | $1,397.36 | $2,195.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,260.49 / $1,667.64 / $1,673.37
| Professional | | $1,260.49 | $1,667.64 | $1,673.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $5,526.00 / $11,083.00
| Facility | | $1,301.00 | $5,526.00 | $11,083.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $960.61 / $1,156.07 / $5,706.18
| Professional | | $960.61 | $1,156.07 | $5,706.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,339.90 / $2,687.10
| Professional | | $6.00 | $1,339.90 | $2,687.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,070.99 / $1,411.58 / $2,306.94
| Professional | | $1,070.99 | $1,411.58 | $2,306.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,052.50 / $1,052.50 / $1,099.14
| Facility | | $1,052.50 | $1,052.50 | $1,099.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,020.50 / $1,057.76 / $1,100.91
| Professional | | $1,020.50 | $1,057.76 | $1,100.91 |
- 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
- $1,066.49 / $1,321.48 / $2,181.33
| Professional | | $1,066.49 | $1,321.48 | $2,181.33 |