- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $4,894.00 / $8,451.00
| Facility | | $921.00 | $4,894.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $679.02 / $771.74 / $1,256.05
| Professional | | $679.02 | $771.74 | $1,256.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,486.23 / $1,486.23 / $1,486.23
| Professional | | $1,486.23 | $1,486.23 | $1,486.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.84 / $1,278.60 / $1,545.48
| Professional | | $812.84 | $1,278.60 | $1,545.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $801.65 / $1,067.35 / $1,671.04
| Professional | | $801.65 | $1,067.35 | $1,671.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $960.04 / $1,276.29 / $1,276.29
| Professional | | $960.04 | $1,276.29 | $1,276.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,991.18 / $21,991.18 / $21,991.18
| Facility | | $21,991.18 | $21,991.18 | $21,991.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.00 / $5,350.00 / $9,900.00
| Facility | | $1,054.00 | $5,350.00 | $9,900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $715.42 / $958.54 / $2,426.03
| Professional | | $715.42 | $958.54 | $2,426.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $6.00 / $2,052.60
| Professional | | $6.00 | $6.00 | $2,052.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $840.17 / $1,089.52 / $1,895.42
| Professional | | $840.17 | $1,089.52 | $1,895.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.60 / $801.60 / $897.84
| Facility | | $801.60 | $801.60 | $897.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $774.44 / $808.30 / $897.84
| Professional | | $774.44 | $808.30 | $897.84 |
- 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
- $815.58 / $1,026.84 / $1,647.82
| Professional | | $815.58 | $1,026.84 | $1,647.82 |