- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,630.78 / $5,623.41
| Facility | | $1,949.84 | $3,630.78 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $602.56 / $1,698.24
| Professional | | $478.63 | $602.56 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $6,309.57 / $33,884.42
| Facility | | $1,288.25 | $6,309.57 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $812.83 / $3,890.45
| Professional | | $446.68 | $812.83 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $1,000.00 / $1,862.09
| Professional | | $549.54 | $1,000.00 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $812.83 / $7,079.46
| Facility | | $302.00 | $812.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $562.34 / $831.76
| Professional | | $295.12 | $562.34 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $954.99 / $1,513.56
| Professional | | $501.19 | $954.99 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $6,456.54 / $33,884.42
| Facility | | $1,288.25 | $6,456.54 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $812.83 / $3,890.45
| Professional | | $446.68 | $812.83 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $12,022.64
| Facility | | $2,041.74 | $5,248.07 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $891.25 / $1,819.70
| Professional | | $588.84 | $891.25 | $1,819.70 |