- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,998.65 / $2,894.76 / $6,117.00
| Facility | | $1,998.65 | $2,894.76 | $6,117.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $711.15 / $1,896.66 / $3,333.75
| Professional | | $711.15 | $1,896.66 | $3,333.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,591.00 / $5,063.00 / $16,742.00
| Facility | | $1,591.00 | $5,063.00 | $16,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $752.69 / $2,636.15 / $16,950.43
| Professional | | $752.69 | $2,636.15 | $16,950.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.28 / $1,044.26 / $2,048.36
| Facility | | $803.28 | $1,044.26 | $2,048.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $952.67 / $2,353.46 / $5,553.63
| Professional | | $952.67 | $2,353.46 | $5,553.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $686.01 / $1,464.70 / $6,679.00
| Facility | | $686.01 | $1,464.70 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $994.53 / $1,915.22 / $3,050.48
| Professional | | $994.53 | $1,915.22 | $3,050.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $875.79 / $1,913.24 / $4,247.58
| Professional | | $875.79 | $1,913.24 | $4,247.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,863.50 / $3,863.50 / $12,164.18
| Facility | | $3,863.50 | $3,863.50 | $12,164.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,304.16 / $1,442.09 / $2,199.00
| Professional | | $1,304.16 | $1,442.09 | $2,199.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $6,204.00 / $26,542.00
| Facility | | $2,324.00 | $6,204.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,000.81 / $4,884.53 / $16,950.43
| Professional | | $2,000.81 | $4,884.53 | $16,950.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $5,097.00 / $10,764.00
| Facility | | $2,324.00 | $5,097.00 | $10,764.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,094.67 / $3,311.19 / $6,370.87
| Professional | | $1,094.67 | $3,311.19 | $6,370.87 |