- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,596.00 / $10,836.00
| Facility | | $969.00 | $3,596.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,516.77 / $1,735.31 / $2,073.07
| Professional | | $1,516.77 | $1,735.31 | $2,073.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,575.55 / $2,598.85 / $6,740.76
| Facility | | $1,575.55 | $2,598.85 | $6,740.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,408.19 / $1,782.42 / $2,483.31
| Professional | | $1,408.19 | $1,782.42 | $2,483.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,455.72 / $1,455.72 / $1,455.72
| Facility | | $1,455.72 | $1,455.72 | $1,455.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,588.66 / $2,091.16 / $3,280.59
| Professional | | $1,588.66 | $2,091.16 | $3,280.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $36,167.46
| Facility | | $55.00 | $55.00 | $36,167.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18,154.00 / $18,154.00 / $18,154.00
| Professional | | $18,154.00 | $18,154.00 | $18,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,588.66 / $1,976.72 / $3,532.61
| Facility | | $1,588.66 | $1,976.72 | $3,532.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,937.26 / $2,235.30 / $2,607.85
| Professional | | $1,937.26 | $2,235.30 | $2,607.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,448.49 / $1,588.66 / $2,593.16
| Professional | | $1,448.49 | $1,588.66 | $2,593.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,588.66 / $2,054.81 / $3,925.81
| Facility | | $1,588.66 | $2,054.81 | $3,925.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,588.66 / $2,151.75 / $3,542.43
| Professional | | $1,588.66 | $2,151.75 | $3,542.43 |
- 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
- $1,305.00 / $1,718.36 / $2,712.49
| Professional | | $1,305.00 | $1,718.36 | $2,712.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,271.83 / $1,455.67 / $1,994.41
| Professional | | $1,271.83 | $1,455.67 | $1,994.41 |