- 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
- $2,968.05 / $3,403.64 / $4,068.54
| Professional | | $2,968.05 | $3,403.64 | $4,068.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,758.20 / $3,491.21 / $4,864.03
| Professional | | $2,758.20 | $3,491.21 | $4,864.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,809.74 / $2,809.74 / $2,809.74
| Facility | | $2,809.74 | $2,809.74 | $2,809.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,104.33 / $4,084.38 / $6,418.87
| Professional | | $3,104.33 | $4,084.38 | $6,418.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $70,621.53
| Facility | | $55.00 | $55.00 | $70,621.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23,442.30 / $24,379.99 / $25,622.85
| Professional | | $23,442.30 | $24,379.99 | $25,622.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,885.37 / $3,709.32 / $6,855.63
| Facility | | $2,885.37 | $3,709.32 | $6,855.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,786.22 / $4,368.72 / $5,096.84
| Professional | | $3,786.22 | $4,368.72 | $5,096.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,678.00 / $3,678.00 / $3,678.00
| Professional | | $3,678.00 | $3,678.00 | $3,678.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,885.37 / $3,723.55 / $7,689.43
| Facility | | $2,885.37 | $3,723.55 | $7,689.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,951.59 / $4,200.78 / $6,925.23
| Professional | | $2,951.59 | $4,200.78 | $6,925.23 |
- 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
- $2,490.16 / $3,375.98 / $5,257.21
| Professional | | $2,490.16 | $3,375.98 | $5,257.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,485.71 / $2,849.16 / $3,895.25
| Professional | | $2,485.71 | $2,849.16 | $3,895.25 |