- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,682.00 / $12,281.00
| Facility | | $969.00 | $3,682.00 | $12,281.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,935.47 / $3,469.19 / $4,172.13
| Professional | | $2,935.47 | $3,469.19 | $4,172.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,828.37 / $3,580.03 / $4,878.43
| Professional | | $2,828.37 | $3,580.03 | $4,878.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,873.78 / $2,873.78 / $2,873.78
| Facility | | $2,873.78 | $2,873.78 | $2,873.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,094.03 / $4,071.44 / $5,732.24
| Professional | | $3,094.03 | $4,071.44 | $5,732.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $72,378.60
| Facility | | $55.00 | $55.00 | $72,378.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,519.40 / $23,262.54 / $26,268.08
| Professional | | $22,519.40 | $23,262.54 | $26,268.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,921.54 / $3,718.45 / $7,030.15
| Facility | | $2,921.54 | $3,718.45 | $7,030.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,881.25 / $4,478.37 / $5,224.77
| Professional | | $3,881.25 | $4,478.37 | $5,224.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,860.44 / $3,192.82 / $5,179.92
| Professional | | $2,860.44 | $3,192.82 | $5,179.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,921.54 / $3,746.67 / $7,209.69
| Facility | | $2,921.54 | $3,746.67 | $7,209.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,026.93 / $4,205.25 / $6,593.13
| Professional | | $3,026.93 | $4,205.25 | $6,593.13 |
- 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
- $2,481.51 / $3,301.12 / $5,324.71
| Professional | | $2,481.51 | $3,301.12 | $5,324.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,548.10 / $2,921.54 / $3,992.42
| Professional | | $2,548.10 | $2,921.54 | $3,992.42 |