- 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
- $1,988.51 / $2,282.21 / $2,727.81
| Professional | | $1,988.51 | $2,282.21 | $2,727.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,857.57 / $2,351.23 / $3,275.80
| Professional | | $1,857.57 | $2,351.23 | $3,275.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,860.19 / $1,860.19 / $1,860.19
| Facility | | $1,860.19 | $1,860.19 | $1,860.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,103.06 / $2,733.62 / $4,298.37
| Professional | | $2,103.06 | $2,733.62 | $4,298.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $47,417.37
| Facility | | $55.00 | $55.00 | $47,417.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20,369.00 / $20,369.00 / $20,369.00
| Professional | | $20,369.00 | $20,369.00 | $20,369.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,939.55 / $2,492.30 / $4,584.18
| Facility | | $1,939.55 | $2,492.30 | $4,584.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,548.26 / $2,940.30 / $3,430.35
| Professional | | $2,548.26 | $2,940.30 | $3,430.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,850.65 / $2,103.06 / $3,393.27
| Professional | | $1,850.65 | $2,103.06 | $3,393.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,939.55 / $2,492.57 / $5,178.63
| Facility | | $1,939.55 | $2,492.57 | $5,178.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,027.47 / $2,809.28 / $4,659.30
| Professional | | $2,027.47 | $2,809.28 | $4,659.30 |
- 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
- $1,726.53 / $2,266.07 / $3,613.71
| Professional | | $1,726.53 | $2,266.07 | $3,613.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,672.97 / $1,917.36 / $2,618.19
| Professional | | $1,672.97 | $1,917.36 | $2,618.19 |