- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.00 / $5,298.00 / $10,170.00
| Facility | | $1,819.00 | $5,298.00 | $10,170.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $689.00 / $1,009.44 / $1,218.00
| Professional | | $689.00 | $1,009.44 | $1,218.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,385.00 / $4,133.00 / $9,074.00
| Facility | | $2,385.00 | $4,133.00 | $9,074.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.01 / $555.11 / $1,116.74
| Professional | | $447.01 | $555.11 | $1,116.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $986.46 / $986.46 / $5,701.51
| Facility | | $986.46 | $986.46 | $5,701.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,805.78 / $3,805.78 / $3,805.78
| Professional | | $3,805.78 | $3,805.78 | $3,805.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.00 / $1,248.60 / $2,674.46
| Facility | | $294.00 | $1,248.60 | $2,674.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,188.65 / $1,426.38 / $2,213.28
| Professional | | $1,188.65 | $1,426.38 | $2,213.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $982.11 / $1,416.18 / $2,165.58
| Professional | | $982.11 | $1,416.18 | $2,165.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $986.46 / $74,999.25
| Facility | | $555.00 | $986.46 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,805.78 / $3,805.78 / $3,805.78
| Professional | | $3,805.78 | $3,805.78 | $3,805.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,031.00 / $3,972.00 / $8,208.00
| Facility | | $2,031.00 | $3,972.00 | $8,208.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $887.46 / $1,168.13 / $2,368.98
| Professional | | $887.46 | $1,168.13 | $2,368.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $982.11 / $982.11 / $982.11
| Facility | | $982.11 | $982.11 | $982.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $982.11 / $982.11 / $2,165.58
| Professional | | $982.11 | $982.11 | $2,165.58 |