- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.34 / $4,597.00 / $9,211.00
| Facility | | $1,031.34 | $4,597.00 | $9,211.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $918.30 / $1,010.12 / $1,327.71
| Professional | | $918.30 | $1,010.12 | $1,327.71 |
- 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
- $1,027.10 / $1,065.86 / $1,065.86
| Professional | | $1,027.10 | $1,065.86 | $1,065.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $915.27 / $1,305.58 / $2,181.08
| Professional | | $915.27 | $1,305.58 | $2,181.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,242.05 / $1,663.85 / $1,663.85
| Professional | | $1,242.05 | $1,663.85 | $1,663.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,408.23 / $7,408.23 / $13,203.05
| Facility | | $7,408.23 | $7,408.23 | $13,203.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,761.00 / $8,427.00
| Facility | | $1,020.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $918.30 / $1,031.34 / $4,831.00
| Professional | | $918.30 | $1,031.34 | $4,831.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,221.09 / $2,598.30
| Professional | | $6.00 | $1,221.09 | $2,598.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $992.21 / $1,327.67 / $2,181.08
| Professional | | $992.21 | $1,327.67 | $2,181.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,005.11 / $1,005.11 / $1,054.69
| Facility | | $1,005.11 | $1,005.11 | $1,054.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $964.59 / $1,019.84 / $1,059.85
| Professional | | $964.59 | $1,019.84 | $1,059.85 |
- 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
- $947.85 / $1,287.55 / $2,073.21
| Professional | | $947.85 | $1,287.55 | $2,073.21 |