- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,656.91 / $2,940.52 / $10,775.73
| Facility | | $1,656.91 | $2,940.52 | $10,775.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $771.94 / $984.86 / $4,830.08
| Professional | | $771.94 | $984.86 | $4,830.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,939.00 / $5,097.00 / $16,742.00
| Facility | | $1,939.00 | $5,097.00 | $16,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $816.33 / $1,722.63 / $7,712.32
| Professional | | $816.33 | $1,722.63 | $7,712.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,737.39 / $1,737.39 / $1,737.39
| Professional | | $1,737.39 | $1,737.39 | $1,737.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.45 / $1,915.88 / $3,481.92
| Professional | | $1,148.45 | $1,915.88 | $3,481.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $886.68 / $1,909.00 / $6,679.00
| Facility | | $886.68 | $1,909.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,017.47 / $1,285.69 / $2,288.89
| Professional | | $1,017.47 | $1,285.69 | $2,288.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,090.35 / $2,174.61 / $2,898.18
| Professional | | $1,090.35 | $2,174.61 | $2,898.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.82 / $1,420.80 / $16,271.47
| Facility | | $0.82 | $1,420.80 | $16,271.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,632.27 / $2,909.44 / $2,909.44
| Professional | | $1,632.27 | $2,909.44 | $2,909.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $6,280.00 / $26,542.00
| Facility | | $2,324.00 | $6,280.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $984.80 / $1,931.80 / $7,712.32
| Professional | | $984.80 | $1,931.80 | $7,712.32 |
- 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
- $930.51 / $1,386.19 / $3,033.30
| Professional | | $930.51 | $1,386.19 | $3,033.30 |