- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.00 / $3,682.00 / $12,826.00
| Facility | | $1,002.00 | $3,682.00 | $12,826.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,075.10 / $2,536.12 / $4,017.42
| Professional | | $2,075.10 | $2,536.12 | $4,017.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,306.96 / $2,920.05 / $3,979.10
| Professional | | $2,306.96 | $2,920.05 | $3,979.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $2,184.05 / $2,247.05
| Facility | | $80.00 | $2,184.05 | $2,247.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,847.41 / $2,847.41 / $2,847.41
| Facility | | $2,847.41 | $2,847.41 | $2,847.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,282.17 / $3,180.81 / $4,773.09
| Professional | | $2,282.17 | $3,180.81 | $4,773.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $31,365.73
| Facility | | $55.00 | $55.00 | $31,365.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17,975.28 / $18,356.48 / $21,440.78
| Professional | | $17,975.28 | $18,356.48 | $21,440.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,848.34 / $2,625.19 / $4,180.22
| Facility | | $1,848.34 | $2,625.19 | $4,180.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,066.05 / $3,679.26 / $4,562.28
| Professional | | $3,066.05 | $3,679.26 | $4,562.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,586.05 / $2,906.30 / $4,289.80
| Professional | | $2,586.05 | $2,906.30 | $4,289.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,848.34 / $2,637.13 / $4,323.87
| Facility | | $1,848.34 | $2,637.13 | $4,323.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,305.28 / $3,357.02 / $5,196.35
| Professional | | $2,305.28 | $3,357.02 | $5,196.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $7,123.00 / $16,000.00
| Facility | | $2,600.00 | $7,123.00 | $16,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,961.36 / $2,615.15 / $4,071.23
| Professional | | $1,961.36 | $2,615.15 | $4,071.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,093.42 / $2,386.54 / $3,294.92
| Professional | | $2,093.42 | $2,386.54 | $3,294.92 |