- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,677.95 / $10,836.00
| Facility | | $969.00 | $3,677.95 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,321.39 / $2,662.11 / $3,182.29
| Professional | | $2,321.39 | $2,662.11 | $3,182.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,157.67 / $2,731.10 / $3,805.03
| Professional | | $2,157.67 | $2,731.10 | $3,805.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,198.83 / $2,198.83 / $2,198.83
| Facility | | $2,198.83 | $2,198.83 | $2,198.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,309.59 / $3,144.11 / $5,033.79
| Professional | | $2,309.59 | $3,144.11 | $5,033.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $55,249.32
| Facility | | $55.00 | $55.00 | $55,249.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18,209.83 / $18,938.22 / $20,043.83
| Professional | | $18,209.83 | $18,938.22 | $20,043.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.16 / $2,838.19 / $5,366.55
| Facility | | $2,088.16 | $2,838.19 | $5,366.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,962.04 / $3,417.74 / $3,987.36
| Professional | | $2,962.04 | $3,417.74 | $3,987.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,187.92 / $2,435.31 / $3,952.54
| Professional | | $2,187.92 | $2,435.31 | $3,952.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.16 / $2,885.02 / $5,989.76
| Facility | | $2,088.16 | $2,885.02 | $5,989.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,255.94 / $3,239.07 / $5,677.49
| Professional | | $2,255.94 | $3,239.07 | $5,677.49 |
- 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
- $1,951.25 / $2,620.25 / $4,112.41
| Professional | | $1,951.25 | $2,620.25 | $4,112.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,944.62 / $2,229.06 / $3,047.34
| Professional | | $1,944.62 | $2,229.06 | $3,047.34 |