- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,824.74 / $2,900.00 / $6,107.00
| Facility | | $1,824.74 | $2,900.00 | $6,107.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.93 / $1,423.33 / $3,650.51
| Professional | | $342.93 | $1,423.33 | $3,650.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.49 / $4,983.00 / $15,220.00
| Facility | | $590.49 | $4,983.00 | $15,220.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.51 / $3,205.89 / $14,339.95
| Professional | | $308.51 | $3,205.89 | $14,339.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.02 / $364.04 / $715.48
| Facility | | $280.02 | $364.04 | $715.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.76 / $749.08 / $6,619.02
| Professional | | $356.76 | $749.08 | $6,619.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.99 / $1,118.45 / $6,189.83
| Professional | | $344.99 | $1,118.45 | $6,189.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.69 / $510.62 / $6,679.00
| Facility | | $244.69 | $510.62 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,285.61 / $2,481.23 / $3,724.38
| Professional | | $1,285.61 | $2,481.23 | $3,724.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.01 / $2,417.87 / $5,367.91
| Professional | | $309.01 | $2,417.87 | $5,367.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,223.07 / $4,660.42 / $13,028.74
| Facility | | $4,223.07 | $4,660.42 | $13,028.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.18 / $554.05 / $4,575.00
| Professional | | $376.18 | $554.05 | $4,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $5,572.00 / $26,542.00
| Facility | | $2,155.00 | $5,572.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,387.82 / $4,878.08 / $14,339.95
| Professional | | $2,387.82 | $4,878.08 | $14,339.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,360.21 / $3,365.80 / $6,535.09
| Professional | | $2,360.21 | $3,365.80 | $6,535.09 |