- 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
- $2,453.98 / $2,900.16 / $3,447.86
| Professional | | $2,453.98 | $2,900.16 | $3,447.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,379.29 / $3,011.61 / $4,138.64
| Professional | | $2,379.29 | $3,011.61 | $4,138.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,404.09 / $2,404.09 / $2,404.09
| Facility | | $2,404.09 | $2,404.09 | $2,404.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,144.86 / $3,305.61 / $4,598.99
| Professional | | $2,144.86 | $3,305.61 | $4,598.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $60,280.92
| Facility | | $55.00 | $55.00 | $60,280.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18,058.88 / $18,490.64 / $21,865.65
| Professional | | $18,058.88 | $18,490.64 | $21,865.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,931.88 / $2,916.78 / $5,772.41
| Facility | | $1,931.88 | $2,916.78 | $5,772.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,231.16 / $3,728.27 / $4,349.64
| Professional | | $3,231.16 | $3,728.27 | $4,349.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,387.40 / $2,387.40 / $2,387.40
| Professional | | $2,387.40 | $2,387.40 | $2,387.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,931.88 / $2,916.78 / $5,960.77
| Facility | | $1,931.88 | $2,916.78 | $5,960.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,180.75 / $3,362.97 / $5,336.79
| Professional | | $2,180.75 | $3,362.97 | $5,336.79 |
- 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
- $2,027.46 / $2,687.41 / $4,387.60
| Professional | | $2,027.46 | $2,687.41 | $4,387.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,121.31 / $2,430.65 / $3,324.73
| Professional | | $2,121.31 | $2,430.65 | $3,324.73 |