- 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
- $1,753.97 / $2,009.51 / $2,400.64
| Professional | | $1,753.97 | $2,009.51 | $2,400.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,635.65 / $2,070.33 / $2,884.44
| Professional | | $1,635.65 | $2,070.33 | $2,884.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,654.11 / $1,654.11 / $1,654.11
| Facility | | $1,654.11 | $1,654.11 | $1,654.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,851.73 / $2,444.57 / $4,007.00
| Professional | | $1,851.73 | $2,444.57 | $4,007.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $51,840.36
| Facility | | $55.00 | $55.00 | $51,840.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,841.00 / $24,074.39 / $24,074.39
| Professional | | $22,841.00 | $24,074.39 | $24,074.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.73 / $2,342.40 / $4,444.78
| Facility | | $1,851.73 | $2,342.40 | $4,444.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,248.44 / $2,594.36 / $3,026.75
| Professional | | $2,248.44 | $2,594.36 | $3,026.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,118.00 / $3,118.00 / $3,118.00
| Professional | | $3,118.00 | $3,118.00 | $3,118.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.73 / $2,407.25 / $4,731.54
| Facility | | $1,851.73 | $2,407.25 | $4,731.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,851.73 / $2,500.15 / $4,090.14
| Professional | | $1,851.73 | $2,500.15 | $4,090.14 |
- 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
- $1,506.10 / $1,987.55 / $3,130.40
| Professional | | $1,506.10 | $1,987.55 | $3,130.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,476.14 / $1,689.83 / $2,311.46
| Professional | | $1,476.14 | $1,689.83 | $2,311.46 |