- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,012.00 / $1,438.77 / $1,686.00
| Facility | | $1,012.00 | $1,438.77 | $1,686.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $917.13 / $1,062.14 / $1,438.77
| Professional | | $917.13 | $1,062.14 | $1,438.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $932.12 / $2,064.48 / $10,816.76
| Facility | | $932.12 | $2,064.48 | $10,816.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.44 / $478.93 / $1,581.80
| Professional | | $145.44 | $478.93 | $1,581.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,161.33 / $1,337.96 / $2,895.23
| Facility | | $1,161.33 | $1,337.96 | $2,895.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,031.50 / $1,445.65 / $2,283.44
| Professional | | $1,031.50 | $1,445.65 | $2,283.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $971.17 / $1,479.87 / $4,933.81
| Professional | | $971.17 | $1,479.87 | $4,933.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,202.40 / $1,238.46 / $1,342.39
| Professional | | $1,202.40 | $1,238.46 | $1,342.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $125.20 / $1,352.18
| Professional | | $32.34 | $125.20 | $1,352.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $934.80 / $1,399.54 / $2,121.19
| Professional | | $934.80 | $1,399.54 | $2,121.19 |