- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,528.00 / $2,894.76 / $6,117.00
| Facility | | $2,528.00 | $2,894.76 | $6,117.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,232.44 / $1,372.83 / $2,000.00
| Professional | | $1,232.44 | $1,372.83 | $2,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,381.63 / $4,621.47 / $10,174.20
| Facility | | $1,381.63 | $4,621.47 | $10,174.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,276.56 / $2,458.06 / $8,936.87
| Professional | | $1,276.56 | $2,458.06 | $8,936.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,696.94 / $2,336.39 / $3,811.34
| Professional | | $1,696.94 | $2,336.39 | $3,811.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,423.69 / $2,545.05 / $4,612.64
| Professional | | $1,423.69 | $2,545.05 | $4,612.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $1,925.18 / $8,090.00
| Facility | | $300.00 | $1,925.18 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.94 / $1,398.19 / $2,254.17
| Professional | | $750.94 | $1,398.19 | $2,254.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,529.45 / $3,050.34 / $4,468.70
| Professional | | $1,529.45 | $3,050.34 | $4,468.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,320.31 / $5,301.97 / $21,582.50
| Facility | | $4,320.31 | $5,301.97 | $21,582.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,097.00 / $12,850.00
| Facility | | $55.00 | $5,097.00 | $12,850.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,439.19 / $2,597.98 / $8,936.87
| Professional | | $1,439.19 | $2,597.98 | $8,936.87 |
- 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
- $1,419.80 / $1,841.98 / $4,251.82
| Professional | | $1,419.80 | $1,841.98 | $4,251.82 |