- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.30 / $2,266.00 / $9,184.98
| Facility | | $489.30 | $2,266.00 | $9,184.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.33 / $801.42 / $1,428.15
| Professional | | $315.33 | $801.42 | $1,428.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $726.61 / $1,059.60 / $1,459.34
| Professional | | $726.61 | $1,059.60 | $1,459.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.89 / $706.10 / $1,605.62
| Professional | | $362.89 | $706.10 | $1,605.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $996.11 / $1,320.27 / $1,356.30
| Professional | | $996.11 | $1,320.27 | $1,356.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,146.07 / $7,824.86 / $12,676.20
| Facility | | $2,146.07 | $7,824.86 | $12,676.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.00 / $2,152.00 / $8,922.00
| Facility | | $530.00 | $2,152.00 | $8,922.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.64 / $808.39 / $1,821.14
| Professional | | $341.64 | $808.39 | $1,821.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $1,292.20 / $2,428.50
| Professional | | $3.00 | $1,292.20 | $2,428.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.50 / $777.12 / $1,605.62
| Professional | | $369.50 | $777.12 | $1,605.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.16 / $600.96 / $1,302.89
| Facility | | $334.16 | $600.96 | $1,302.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.16 / $841.42 / $920.92
| Professional | | $334.16 | $841.42 | $920.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $811.04 / $1,112.32 / $1,721.87
| Professional | | $811.04 | $1,112.32 | $1,721.87 |