- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,758.00 / $2,747.00 / $5,454.00
| Facility | | $1,758.00 | $2,747.00 | $5,454.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $975.61 / $1,173.93 / $3,168.03
| Professional | | $975.61 | $1,173.93 | $3,168.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,939.00 / $5,097.00 / $16,742.00
| Facility | | $1,939.00 | $5,097.00 | $16,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $922.64 / $1,899.09 / $7,307.00
| Professional | | $922.64 | $1,899.09 | $7,307.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.57 / $1,114.31 / $2,000.08
| Professional | | $390.57 | $1,114.31 | $2,000.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,114.46 / $1,925.80 / $3,539.41
| Professional | | $1,114.46 | $1,925.80 | $3,539.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.75 / $1,909.00 / $6,679.00
| Facility | | $953.75 | $1,909.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $587.79 / $1,120.94 / $1,764.44
| Professional | | $587.79 | $1,120.94 | $1,764.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,189.89 / $2,373.12 / $3,447.37
| Professional | | $1,189.89 | $2,373.12 | $3,447.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.82 / $4,501.87 / $4,580.53
| Facility | | $0.82 | $4,501.87 | $4,580.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.87 / $275.87 / $310.13
| Professional | | $275.87 | $275.87 | $310.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $6,280.00 / $26,542.00
| Facility | | $2,324.00 | $6,280.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,158.35 / $2,131.29 / $7,307.00
| Professional | | $1,158.35 | $2,131.29 | $7,307.00 |
- 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
- $1,089.63 / $1,591.65 / $3,497.38
| Professional | | $1,089.63 | $1,591.65 | $3,497.38 |