- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,203.07 / $5,254.00 / $10,637.25
| Facility | | $1,203.07 | $5,254.00 | $10,637.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $998.84 / $1,116.05 / $2,914.02
| Professional | | $998.84 | $1,116.05 | $2,914.02 |
- 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
- $965.11 / $1,535.90 / $2,070.09
| Professional | | $965.11 | $1,535.90 | $2,070.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,034.30 / $1,408.06 / $2,266.19
| Professional | | $1,034.30 | $1,408.06 | $2,266.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,304.71 / $1,730.85 / $1,745.58
| Professional | | $1,304.71 | $1,730.85 | $1,745.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,834.96 / $10,834.96 / $12,495.40
| Facility | | $10,834.96 | $10,834.96 | $12,495.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $5,526.00 / $11,083.00
| Facility | | $1,301.00 | $5,526.00 | $11,083.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $998.84 / $1,203.07 / $5,828.04
| Professional | | $998.84 | $1,203.07 | $5,828.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $1,290.30 / $2,909.20
| Professional | | $5.00 | $1,290.30 | $2,909.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,069.64 / $1,424.82 / $2,358.85
| Professional | | $1,069.64 | $1,424.82 | $2,358.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.03 / $1,093.03 / $1,359.36
| Facility | | $1,093.03 | $1,093.03 | $1,359.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,066.33 / $1,093.03 / $1,359.36
| Professional | | $1,066.33 | $1,093.03 | $1,359.36 |
- 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
- $953.22 / $1,324.19 / $2,174.69
| Professional | | $953.22 | $1,324.19 | $2,174.69 |