- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $3,090.30 / $8,511.38
| Facility | | $1,148.15 | $3,090.30 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,380.38 / $4,265.80
| Professional | | $1,000.00 | $1,380.38 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,630.78 / $9,120.11
| Facility | | $56.23 | $3,630.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $1,659.59 / $8,317.64
| Professional | | $977.24 | $1,659.59 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,467.37 / $3,630.78
| Professional | | $1,862.09 | $3,467.37 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,041.74 / $3,801.89
| Professional | | $1,096.48 | $2,041.74 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,995.26 / $7,762.47
| Facility | | $1,023.29 | $1,995.26 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,174.90 / $1,737.80
| Professional | | $602.56 | $1,174.90 | $1,737.80 |
- 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
- $1,047.13 / $1,862.09 / $2,884.03
| Professional | | $1,047.13 | $1,862.09 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $20,892.96 / $20,892.96
| Facility | | $5,495.41 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,801.89 / $9,120.11
| Facility | | $56.23 | $3,801.89 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $1,659.59 / $8,317.64
| Professional | | $977.24 | $1,659.59 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,570.88 / $9,332.54
| Facility | | $2,041.74 | $4,570.88 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,778.28 / $3,715.35
| Professional | | $1,230.27 | $1,778.28 | $3,715.35 |