- 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
- $2,180.33 / $2,534.78 / $3,051.62
| Professional | | $2,180.33 | $2,534.78 | $3,051.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,078.57 / $2,630.97 / $3,665.53
| Professional | | $2,078.57 | $2,630.97 | $3,665.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,057.51 / $2,057.51 / $2,057.51
| Facility | | $2,057.51 | $2,057.51 | $2,057.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,308.66 / $2,934.82 / $4,070.17
| Professional | | $2,308.66 | $2,934.82 | $4,070.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $52,435.11
| Facility | | $55.00 | $55.00 | $52,435.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,715.36 / $16,112.08 / $19,052.48
| Professional | | $15,715.36 | $16,112.08 | $19,052.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,147.71 / $2,681.24 / $5,128.92
| Facility | | $2,147.71 | $2,681.24 | $5,128.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,814.44 / $3,247.43 / $3,788.66
| Professional | | $2,814.44 | $3,247.43 | $3,788.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,048.21 / $2,237.87 / $3,753.28
| Professional | | $2,048.21 | $2,237.87 | $3,753.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,147.71 / $2,755.64 / $5,249.88
| Facility | | $2,147.71 | $2,755.64 | $5,249.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,308.66 / $3,075.20 / $4,664.42
| Professional | | $2,308.66 | $3,075.20 | $4,664.42 |
- 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
- $1,899.30 / $2,661.79 / $5,333.19
| Professional | | $1,899.30 | $2,661.79 | $5,333.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,847.72 / $2,121.48 / $2,893.08
| Professional | | $1,847.72 | $2,121.48 | $2,893.08 |