- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $3,839.00 / $8,247.00
| Facility | | $1,020.00 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,854.17 / $2,069.52 / $3,281.37
| Professional | | $1,854.17 | $2,069.52 | $3,281.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,012.35 / $2,088.28 / $2,088.28
| Professional | | $2,012.35 | $2,088.28 | $2,088.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,842.40 / $2,571.71 / $4,132.22
| Professional | | $1,842.40 | $2,571.71 | $4,132.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,393.32 / $3,174.76 / $3,195.61
| Professional | | $2,393.32 | $3,174.76 | $3,195.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,456.33 / $11,456.33 / $11,456.33
| Facility | | $11,456.33 | $11,456.33 | $11,456.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,892.70 / $2,242.51 / $5,447.24
| Professional | | $1,892.70 | $2,242.51 | $5,447.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $2,089.10 / $5,286.60
| Professional | | $6.00 | $2,089.10 | $5,286.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,898.44 / $2,604.41 / $4,266.72
| Professional | | $1,898.44 | $2,604.41 | $4,266.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,983.21 / $1,997.74 / $1,997.74
| Facility | | $1,983.21 | $1,997.74 | $1,997.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,946.44 / $1,997.74 / $2,118.44
| Professional | | $1,946.44 | $1,997.74 | $2,118.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,700.25 / $2,467.96 / $4,335.39
| Professional | | $1,700.25 | $2,467.96 | $4,335.39 |