- 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
- $2,331.16 / $2,674.80 / $3,487.89
| Professional | | $2,331.16 | $2,674.80 | $3,487.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,177.07 / $2,755.64 / $3,839.22
| Professional | | $2,177.07 | $2,755.64 | $3,839.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.19 / $2,187.19 / $2,187.19
| Facility | | $2,187.19 | $2,187.19 | $2,187.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,467.88 / $3,218.97 / $5,014.30
| Professional | | $2,467.88 | $3,218.97 | $5,014.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $55,671.00
| Facility | | $55.00 | $55.00 | $55,671.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21,226.12 / $22,841.74 / $22,841.74
| Professional | | $21,226.12 | $22,841.74 | $22,841.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,362.76 / $2,986.25 / $5,371.13
| Facility | | $2,362.76 | $2,986.25 | $5,371.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,991.47 / $3,451.70 / $4,026.98
| Professional | | $2,991.47 | $3,451.70 | $4,026.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,362.76 / $3,044.01 / $6,616.76
| Facility | | $2,362.76 | $3,044.01 | $6,616.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,467.88 / $3,315.39 / $5,415.44
| Professional | | $2,467.88 | $3,315.39 | $5,415.44 |
- 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
- $2,022.18 / $2,660.23 / $4,245.43
| Professional | | $2,022.18 | $2,660.23 | $4,245.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,963.95 / $2,250.25 / $3,073.87
| Professional | | $1,963.95 | $2,250.25 | $3,073.87 |