- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,596.00 / $10,836.00
| Facility | | $969.00 | $3,596.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,848.14 / $2,214.67 / $2,939.51
| Professional | | $1,848.14 | $2,214.67 | $2,939.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,060.82 / $3,511.81 / $17,571.66
| Facility | | $2,060.82 | $3,511.81 | $17,571.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,708.38 / $2,283.11 / $3,274.17
| Professional | | $1,708.38 | $2,283.11 | $3,274.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,708.50 / $1,708.50 / $1,708.50
| Facility | | $1,708.50 | $1,708.50 | $1,708.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,991.09 / $2,695.89 / $4,233.02
| Professional | | $1,991.09 | $2,695.89 | $4,233.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $18,280.24
| Facility | | $55.00 | $55.00 | $18,280.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,504.56 / $14,927.92 / $16,832.09
| Professional | | $14,504.56 | $14,927.92 | $16,832.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,945.70 / $2,431.53 / $4,461.16
| Facility | | $1,945.70 | $2,431.53 | $4,461.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,145.54 / $2,984.25 / $3,510.88
| Professional | | $2,145.54 | $2,984.25 | $3,510.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,203.80 / $2,203.80 / $2,655.04
| Professional | | $2,203.80 | $2,203.80 | $2,655.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,945.70 / $2,465.40 / $5,016.09
| Facility | | $1,945.70 | $2,465.40 | $5,016.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,025.88 / $2,734.58 / $4,362.43
| Professional | | $2,025.88 | $2,734.58 | $4,362.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,671.38 / $2,246.64 / $3,508.97
| Professional | | $1,671.38 | $2,246.64 | $3,508.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,664.68 / $1,896.46 / $2,631.66
| Professional | | $1,664.68 | $1,896.46 | $2,631.66 |