- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,570.40 / $2,884.03
| Professional | | $2,290.87 | $2,570.40 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $3,801.89 / $15,135.61
| Professional | | $239.88 | $3,801.89 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $10,964.78 / $16,218.10
| Facility | | $9,772.37 | $10,964.78 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,630.78 / $4,466.84 / $9,549.93
| Professional | | $3,630.78 | $4,466.84 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,630.78 / $9,120.11
| Facility | | $2,754.23 | $3,630.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18,197.01 / $18,197.01 / $20,417.38
| Professional | | $18,197.01 | $18,197.01 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $4,073.80 / $10,715.19
| Facility | | $2,754.23 | $4,073.80 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,819.70 / $15,135.61
| Professional | | $1,318.26 | $1,819.70 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $64.57 / $85.11
| Professional | | $50.12 | $64.57 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,248.07 / $6,918.31 / $10,000.00
| Professional | | $5,248.07 | $6,918.31 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $6,025.60 / $14,454.40
| Facility | | $6,025.60 | $6,025.60 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,022.64 / $15,135.61
| Professional | | $4,365.16 | $12,022.64 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,456.54 / $6,456.54
| Professional | | $6,456.54 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16,595.87 / $16,595.87 / $16,595.87
| Professional | | $16,595.87 | $16,595.87 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,819.70 / $5,370.32
| Professional | | $1,288.25 | $1,819.70 | $5,370.32 |