- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,682.00 / $10,893.00
| Facility | | $969.00 | $3,682.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,538.71 / $3,000.29 / $3,609.06
| Professional | | $2,538.71 | $3,000.29 | $3,609.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,468.86 / $2,993.10 / $4,258.35
| Professional | | $2,468.86 | $2,993.10 | $4,258.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,484.44 / $2,484.44 / $2,484.44
| Facility | | $2,484.44 | $2,484.44 | $2,484.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,537.81 / $3,476.07 / $4,961.04
| Professional | | $2,537.81 | $3,476.07 | $4,961.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $48,132.32
| Facility | | $55.00 | $55.00 | $48,132.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18,899.68 / $19,402.80 / $23,001.53
| Professional | | $18,899.68 | $19,402.80 | $23,001.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,385.15 / $3,133.51 / $6,079.24
| Facility | | $2,385.15 | $3,133.51 | $6,079.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,390.95 / $3,912.63 / $4,564.74
| Professional | | $3,390.95 | $3,912.63 | $4,564.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,472.71 / $2,792.67 / $4,516.89
| Professional | | $2,472.71 | $2,792.67 | $4,516.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,385.15 / $3,171.59 / $6,234.50
| Facility | | $2,385.15 | $3,171.59 | $6,234.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,529.40 / $3,529.60 / $5,700.88
| Professional | | $2,529.40 | $3,529.60 | $5,700.88 |
- 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
- $2,152.28 / $2,869.48 / $4,631.34
| Professional | | $2,152.28 | $2,869.48 | $4,631.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,226.21 / $2,550.90 / $3,486.42
| Professional | | $2,226.21 | $2,550.90 | $3,486.42 |