- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,618.00 / $3,625.00 / $8,272.00
| Facility | | $2,618.00 | $3,625.00 | $8,272.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,233.19 / $1,248.33 / $3,504.89
| Professional | | $1,233.19 | $1,248.33 | $3,504.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,036.00 / $6,029.00 / $34,324.12
| Facility | | $2,036.00 | $6,029.00 | $34,324.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,249.06 / $2,311.88 / $25,915.00
| Professional | | $1,249.06 | $2,311.88 | $25,915.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,265.34 / $27,707.71 / $35,837.41
| Facility | | $23,265.34 | $27,707.71 | $35,837.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,698.99 / $14,868.13 / $20,251.00
| Facility | | $7,698.99 | $14,868.13 | $20,251.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,360.50 / $2,720.25 / $4,316.03
| Professional | | $2,360.50 | $2,720.25 | $4,316.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.46 / $1,986.95 / $6,679.00
| Facility | | $1,248.46 | $1,986.95 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $788.15 / $1,475.19 / $2,309.65
| Professional | | $788.15 | $1,475.19 | $2,309.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,588.84 / $3,177.68 / $5,163.72
| Professional | | $1,588.84 | $3,177.68 | $5,163.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,540.00 / $7,827.00 / $17,462.00
| Facility | | $2,540.00 | $7,827.00 | $17,462.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,539.02 / $2,760.78 / $25,915.00
| Professional | | $1,539.02 | $2,760.78 | $25,915.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,540.00 / $7,157.00 / $14,101.00
| Facility | | $2,540.00 | $7,157.00 | $14,101.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,539.02 / $1,860.35 / $4,275.43
| Professional | | $1,539.02 | $1,860.35 | $4,275.43 |