- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.00 / $3,682.00 / $12,729.00
| Facility | | $1,002.00 | $3,682.00 | $12,729.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,082.80 / $1,535.51 / $2,292.73
| Professional | | $1,082.80 | $1,535.51 | $2,292.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,751.81 / $4,940.75 / $10,182.92
| Facility | | $2,751.81 | $4,940.75 | $10,182.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,266.82 / $1,568.50 / $2,148.25
| Professional | | $1,266.82 | $1,568.50 | $2,148.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.94 / $1,185.94 / $1,239.08
| Facility | | $1,185.94 | $1,185.94 | $1,239.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,953.70 / $1,953.70 / $2,017.56
| Facility | | $1,953.70 | $1,953.70 | $2,017.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,279.59 / $1,655.04 / $2,282.94
| Professional | | $1,279.59 | $1,655.04 | $2,282.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,400.56 / $26,542.00 / $26,542.00
| Facility | | $9,400.56 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,961.04 / $10,377.36 / $11,369.55
| Professional | | $9,961.04 | $10,377.36 | $11,369.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,262.40 / $1,568.15 / $2,467.51
| Facility | | $1,262.40 | $1,568.15 | $2,467.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,280.85 / $1,990.28 / $5,306.00
| Professional | | $1,280.85 | $1,990.28 | $5,306.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,276.10 / $1,391.14 / $1,537.03
| Professional | | $1,276.10 | $1,391.14 | $1,537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,262.40 / $1,599.66 / $2,567.81
| Facility | | $1,262.40 | $1,599.66 | $2,567.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,280.85 / $1,702.30 / $2,548.09
| Professional | | $1,280.85 | $1,702.30 | $2,548.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,200.00 / $10,600.00
| Facility | | $1,634.00 | $4,200.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.11 / $1,327.00 / $1,932.38
| Professional | | $977.11 | $1,327.00 | $1,932.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,132.43 / $1,280.85 / $1,799.62
| Professional | | $1,132.43 | $1,280.85 | $1,799.62 |