- 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
- $2,305.94 / $2,697.96 / $3,244.29
| Professional | | $2,305.94 | $2,697.96 | $3,244.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,210.92 / $2,798.50 / $3,852.24
| Professional | | $2,210.92 | $2,798.50 | $3,852.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.35 / $2,224.35 / $2,224.35
| Facility | | $2,224.35 | $2,224.35 | $2,224.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,362.67 / $3,166.57 / $4,436.02
| Professional | | $2,362.67 | $3,166.57 | $4,436.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $56,522.13
| Facility | | $55.00 | $55.00 | $56,522.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23,012.00 / $23,012.00 / $23,012.00
| Professional | | $23,012.00 | $23,012.00 | $23,012.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,232.07 / $2,854.55 / $5,446.00
| Facility | | $2,232.07 | $2,854.55 | $5,446.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,036.46 / $3,503.61 / $4,087.55
| Professional | | $3,036.46 | $3,503.61 | $4,087.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,213.61 / $2,503.66 / $4,040.42
| Professional | | $2,213.61 | $2,503.66 | $4,040.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,232.07 / $2,863.11 / $5,574.45
| Facility | | $2,232.07 | $2,863.11 | $5,574.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,315.42 / $3,219.61 / $5,087.35
| Professional | | $2,315.42 | $3,219.61 | $5,087.35 |
- 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
- $1,922.86 / $2,560.69 / $4,188.68
| Professional | | $1,922.86 | $2,560.69 | $4,188.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,993.48 / $2,283.64 / $3,120.59
| Professional | | $1,993.48 | $2,283.64 | $3,120.59 |