- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,663.12 / $3,111.85 / $8,331.00
| Facility | | $2,663.12 | $3,111.85 | $8,331.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,126.33 / $1,576.50 / $4,999.00
| Professional | | $1,126.33 | $1,576.50 | $4,999.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $6,078.00 / $26,542.00
| Facility | | $2,386.00 | $6,078.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,161.49 / $2,203.53 / $8,009.04
| Professional | | $1,161.49 | $2,203.53 | $8,009.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,519.18 / $2,091.65 / $3,412.10
| Professional | | $1,519.18 | $2,091.65 | $3,412.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,274.56 / $2,274.46 / $4,122.22
| Professional | | $1,274.56 | $2,274.46 | $4,122.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,091.41 / $1,909.00 / $6,679.00
| Facility | | $1,091.41 | $1,909.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.64 / $1,252.39 / $2,019.11
| Professional | | $672.64 | $1,252.39 | $2,019.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,370.52 / $2,733.37 / $4,001.64
| Professional | | $1,370.52 | $2,733.37 | $4,001.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,299.36 / $7,299.36 / $9,331.89
| Facility | | $7,299.36 | $7,299.36 | $9,331.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.93 / $298.42 / $1,799.96
| Professional | | $262.93 | $298.42 | $1,799.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $7,292.00 / $26,542.00
| Facility | | $2,386.00 | $7,292.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,325.13 / $2,325.84 / $8,009.04
| Professional | | $1,325.13 | $2,325.84 | $8,009.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $5,904.00 / $13,017.00
| Facility | | $2,386.00 | $5,904.00 | $13,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,277.36 / $1,719.92 / $3,787.10
| Professional | | $1,277.36 | $1,719.92 | $3,787.10 |