- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,682.00 / $10,836.00
| Facility | | $969.00 | $3,682.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,732.16 / $3,272.34 / $4,413.21
| Professional | | $2,732.16 | $3,272.34 | $4,413.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,756.04 / $3,488.48 / $4,860.22
| Professional | | $2,756.04 | $3,488.48 | $4,860.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,768.11 / $2,768.11 / $2,768.11
| Facility | | $2,768.11 | $2,768.11 | $2,768.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,786.87 / $4,012.72 / $6,191.95
| Professional | | $2,786.87 | $4,012.72 | $6,191.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $63,745.00
| Facility | | $55.00 | $55.00 | $63,745.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21,055.76 / $21,600.72 / $25,721.93
| Professional | | $21,055.76 | $21,600.72 | $25,721.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,419.81 / $3,389.18 / $6,792.23
| Facility | | $2,419.81 | $3,389.18 | $6,792.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,203.01 / $4,455.10 / $5,241.29
| Professional | | $3,203.01 | $4,455.10 | $5,241.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,754.69 / $3,088.28 / $5,036.02
| Professional | | $2,754.69 | $3,088.28 | $5,036.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,419.81 / $3,416.68 / $7,464.48
| Facility | | $2,419.81 | $3,416.68 | $7,464.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,921.43 / $4,127.87 / $6,280.16
| Professional | | $2,921.43 | $4,127.87 | $6,280.16 |
- 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
- $2,500.84 / $3,434.32 / $5,323.82
| Professional | | $2,500.84 | $3,434.32 | $5,323.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,485.16 / $2,847.23 / $3,889.96
| Professional | | $2,485.16 | $2,847.23 | $3,889.96 |