- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $994.10 / $5,342.00 / $12,400.39
| Facility | | $994.10 | $5,342.00 | $12,400.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $959.60 / $1,126.33 / $4,758.00
| Professional | | $959.60 | $1,126.33 | $4,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $981.91 / $1,558.94 / $2,074.86
| Professional | | $981.91 | $1,558.94 | $2,074.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,074.08 / $1,445.92 / $2,253.19
| Professional | | $1,074.08 | $1,445.92 | $2,253.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,312.09 / $1,744.34 / $1,744.34
| Professional | | $1,312.09 | $1,744.34 | $1,744.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,433.20 / $22,173.45 / $35,011.81
| Facility | | $10,433.20 | $22,173.45 | $35,011.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $5,958.00 / $12,474.00
| Facility | | $1,301.00 | $5,958.00 | $12,474.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $990.18 / $1,312.71 / $4,761.00
| Professional | | $990.18 | $1,312.71 | $4,761.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,324.90 / $2,798.10
| Professional | | $6.00 | $1,324.90 | $2,798.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,076.53 / $1,449.68 / $2,490.06
| Professional | | $1,076.53 | $1,449.68 | $2,490.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,097.63 / $1,097.63 / $1,170.58
| Facility | | $1,097.63 | $1,097.63 | $1,170.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,059.40 / $1,107.91 / $1,170.58
| Professional | | $1,059.40 | $1,107.91 | $1,170.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,563.00 / $8,261.00
| Facility | | $2,304.00 | $4,563.00 | $8,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,058.88 / $1,398.33 / $2,265.12
| Professional | | $1,058.88 | $1,398.33 | $2,265.12 |