- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,094.10 / $4,018.60 / $28,412.16
| Facility | | $1,094.10 | $4,018.60 | $28,412.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,002.05 / $1,116.01 / $1,673.64
| Professional | | $1,002.05 | $1,116.01 | $1,673.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,350.00 / $11,989.00 / $43,260.00
| Facility | | $3,350.00 | $11,989.00 | $43,260.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $961.00 / $1,478.75 / $2,040.67
| Professional | | $961.00 | $1,478.75 | $2,040.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,021.15 / $1,301.47 / $1,501.70
| Facility | | $1,021.15 | $1,301.47 | $1,501.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,001.13 / $1,151.30 / $1,501.70
| Professional | | $1,001.13 | $1,151.30 | $1,501.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,561.47 / $6,561.47 / $6,561.47
| Facility | | $6,561.47 | $6,561.47 | $6,561.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,146.21 / $1,443.06 / $2,293.19
| Professional | | $1,146.21 | $1,443.06 | $2,293.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,296.00 / $17,380.00
| Facility | | $5,431.00 | $12,296.00 | $17,380.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,074.29 / $1,336.31 / $1,993.69
| Professional | | $1,074.29 | $1,336.31 | $1,993.69 |