- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $3,938.00 / $8,451.00
| Facility | | $882.00 | $3,938.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $856.17 / $992.01 / $2,769.07
| Professional | | $856.17 | $992.01 | $2,769.07 |
- 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
- $967.11 / $1,003.61 / $1,003.61
| Professional | | $967.11 | $1,003.61 | $1,003.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.05 / $1,247.96 / $1,964.71
| Professional | | $933.05 | $1,247.96 | $1,964.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,125.67 / $1,489.33 / $1,493.98
| Professional | | $1,125.67 | $1,489.33 | $1,493.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,028.20 / $13,448.36 / $19,911.09
| Facility | | $12,028.20 | $13,448.36 | $19,911.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,102.00 / $8,247.00
| Facility | | $1,013.00 | $4,102.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $886.28 / $1,067.66 / $2,933.33
| Professional | | $886.28 | $1,067.66 | $2,933.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $1,336.20 / $2,398.19
| Professional | | $3.00 | $1,336.20 | $2,398.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $957.99 / $1,261.02 / $2,104.44
| Professional | | $957.99 | $1,261.02 | $2,104.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $939.34 / $939.34 / $1,104.72
| Facility | | $939.34 | $939.34 | $1,104.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $910.73 / $944.08 / $1,104.72
| Professional | | $910.73 | $944.08 | $1,104.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $960.98 / $1,233.81 / $1,972.59
| Professional | | $960.98 | $1,233.81 | $1,972.59 |