- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $5,254.00 / $11,022.00
| Facility | | $1,013.00 | $5,254.00 | $11,022.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $930.84 / $1,062.70 / $1,684.50
| Professional | | $930.84 | $1,062.70 | $1,684.50 |
- 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
- $1,119.52 / $1,770.69 / $2,520.62
| Professional | | $1,119.52 | $1,770.69 | $2,520.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,078.49 / $1,454.33 / $2,266.53
| Professional | | $1,078.49 | $1,454.33 | $2,266.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,319.70 / $1,754.55 / $1,754.55
| Professional | | $1,319.70 | $1,754.55 | $1,754.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,291.56 / $6,291.56 / $6,291.56
| Facility | | $6,291.56 | $6,291.56 | $6,291.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $5,742.00 / $11,938.00
| Facility | | $1,301.00 | $5,742.00 | $11,938.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $930.84 / $1,175.31 / $4,654.00
| Professional | | $930.84 | $1,175.31 | $4,654.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,318.20 / $2,813.10
| Professional | | $6.00 | $1,318.20 | $2,813.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,081.25 / $1,458.86 / $2,490.75
| Professional | | $1,081.25 | $1,458.86 | $2,490.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,103.57 / $1,103.57 / $1,247.82
| Facility | | $1,103.57 | $1,103.57 | $1,247.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,065.10 / $1,113.93 / $1,247.82
| Professional | | $1,065.10 | $1,113.93 | $1,247.82 |
- 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
- $1,079.19 / $1,368.84 / $2,406.14
| Professional | | $1,079.19 | $1,368.84 | $2,406.14 |