- 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
- $3,159.88 / $3,825.11 / $5,107.70
| Professional | | $3,159.88 | $3,825.11 | $5,107.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,187.89 / $4,035.09 / $5,621.78
| Professional | | $3,187.89 | $4,035.09 | $5,621.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,224.88 / $3,224.88 / $3,224.88
| Facility | | $3,224.88 | $3,224.88 | $3,224.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,082.85 / $4,637.74 / $7,277.65
| Professional | | $3,082.85 | $4,637.74 | $7,277.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $62,216.00
| Facility | | $55.00 | $55.00 | $62,216.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24,402.00 / $25,026.08 / $29,785.05
| Professional | | $24,402.00 | $25,026.08 | $29,785.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,313.54 / $3,951.36 / $7,836.64
| Facility | | $2,313.54 | $3,951.36 | $7,836.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,710.05 / $5,160.34 / $6,070.99
| Professional | | $3,710.05 | $5,160.34 | $6,070.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,208.87 / $3,607.51 / $5,829.75
| Professional | | $3,208.87 | $3,607.51 | $5,829.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,313.54 / $3,954.35 / $8,267.10
| Facility | | $2,313.54 | $3,954.35 | $8,267.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,334.50 / $4,784.41 / $7,714.83
| Professional | | $3,334.50 | $4,784.41 | $7,714.83 |
- 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
- $2,813.76 / $3,881.36 / $6,234.21
| Professional | | $2,813.76 | $3,881.36 | $6,234.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,878.56 / $3,295.29 / $4,507.70
| Professional | | $2,878.56 | $3,295.29 | $4,507.70 |