- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,178.04 / $5,254.00 / $10,398.00
| Facility | | $1,178.04 | $5,254.00 | $10,398.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.62 / $1,059.71 / $1,388.56
| Professional | | $977.62 | $1,059.71 | $1,388.56 |
- 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
- $943.96 / $1,508.33 / $2,024.34
| Professional | | $943.96 | $1,508.33 | $2,024.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,009.70 / $1,363.75 / $2,219.04
| Professional | | $1,009.70 | $1,363.75 | $2,219.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,276.36 / $1,693.12 / $1,708.75
| Professional | | $1,276.36 | $1,693.12 | $1,708.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,270.55 / $24,270.55 / $24,270.55
| Facility | | $24,270.55 | $24,270.55 | $24,270.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $5,511.00 / $11,083.00
| Facility | | $1,301.00 | $5,511.00 | $11,083.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.62 / $1,137.47 / $5,704.34
| Professional | | $977.62 | $1,137.47 | $5,704.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $1,259.80 / $2,850.10
| Professional | | $5.00 | $1,259.80 | $2,850.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,046.97 / $1,395.23 / $2,283.42
| Professional | | $1,046.97 | $1,395.23 | $2,283.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,069.64 / $1,069.64 / $1,253.49
| Facility | | $1,069.64 | $1,069.64 | $1,253.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,044.03 / $1,069.64 / $1,253.49
| Professional | | $1,044.03 | $1,069.64 | $1,253.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $930.81 / $1,337.26 / $2,127.23
| Professional | | $930.81 | $1,337.26 | $2,127.23 |