- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,027.83 / $4,264.00 / $8,247.00
| Facility | | $1,027.83 | $4,264.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $983.69 / $1,155.25 / $2,113.10
| Professional | | $983.69 | $1,155.25 | $2,113.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,107.61 / $2,107.61 / $2,107.61
| Professional | | $2,107.61 | $2,107.61 | $2,107.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,017.27 / $1,604.05 / $2,126.57
| Professional | | $1,017.27 | $1,604.05 | $2,126.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,098.50 / $1,476.10 / $2,325.46
| Professional | | $1,098.50 | $1,476.10 | $2,325.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,360.93 / $1,809.42 / $1,809.42
| Professional | | $1,360.93 | $1,809.42 | $1,809.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,631.34 / $13,423.83 / $46,699.91
| Facility | | $10,631.34 | $13,423.83 | $46,699.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $5,194.00 / $8,247.00
| Facility | | $1,020.00 | $5,194.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,016.00 / $1,259.13 / $3,067.95
| Professional | | $1,016.00 | $1,259.13 | $3,067.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,228.00 / $1,589.20 / $2,911.60
| Professional | | $1,228.00 | $1,589.20 | $2,911.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,099.06 / $1,495.26 / $2,496.44
| Professional | | $1,099.06 | $1,495.26 | $2,496.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $979.94 / $1,138.31 / $1,173.02
| Facility | | $979.94 | $1,138.31 | $1,173.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $979.94 / $1,148.40 / $1,193.95
| Professional | | $979.94 | $1,148.40 | $1,193.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,222.00 / $3,475.00 / $6,000.00
| Facility | | $2,222.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,061.25 / $1,480.54 / $2,504.94
| Professional | | $1,061.25 | $1,480.54 | $2,504.94 |