- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,421.00 / $2,663.12 / $4,767.00
| Facility | | $1,421.00 | $2,663.12 | $4,767.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $938.56 / $1,084.41 / $1,742.25
| Professional | | $938.56 | $1,084.41 | $1,742.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,722.30 / $4,916.00 / $15,169.65
| Facility | | $1,722.30 | $4,916.00 | $15,169.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,006.54 / $1,785.67 / $7,544.16
| Professional | | $1,006.54 | $1,785.67 | $7,544.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,228.48 / $2,014.58 / $2,729.07
| Professional | | $1,228.48 | $2,014.58 | $2,729.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,138.25 / $1,719.57 / $2,881.98
| Professional | | $1,138.25 | $1,719.57 | $2,881.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.90 / $1,811.48 / $6,679.00
| Facility | | $1,040.90 | $1,811.48 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,194.43 / $1,446.85 / $1,971.20
| Professional | | $1,194.43 | $1,446.85 | $1,971.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,301.30 / $2,579.69 / $4,111.89
| Professional | | $1,301.30 | $2,579.69 | $4,111.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,941.55 / $2,941.55 / $2,941.55
| Facility | | $2,941.55 | $2,941.55 | $2,941.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $700.00 / $700.00 / $700.00
| Professional | | $700.00 | $700.00 | $700.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $5,097.00 / $16,394.00
| Facility | | $2,324.00 | $5,097.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,105.96 / $1,921.14 / $7,544.16
| Professional | | $1,105.96 | $1,921.14 | $7,544.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $5,097.00 / $10,764.00
| Facility | | $2,324.00 | $5,097.00 | $10,764.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,098.57 / $1,630.61 / $3,241.02
| Professional | | $1,098.57 | $1,630.61 | $3,241.02 |