- 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
- $1,217.61 / $1,388.75 / $1,672.25
| Professional | | $1,217.61 | $1,388.75 | $1,672.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,135.98 / $1,443.29 / $1,992.89
| Professional | | $1,135.98 | $1,443.29 | $1,992.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,059.41 / $1,059.41 / $1,059.41
| Facility | | $1,059.41 | $1,059.41 | $1,059.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,287.86 / $1,682.06 / $2,642.34
| Professional | | $1,287.86 | $1,682.06 | $2,642.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $14,251.82
| Facility | | $55.00 | $55.00 | $14,251.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,130.96 / $8,951.20 / $9,964.35
| Professional | | $8,130.96 | $8,951.20 | $9,964.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,214.34 / $1,596.22 / $2,777.24
| Facility | | $1,214.34 | $1,596.22 | $2,777.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,464.62 / $1,689.95 / $1,971.60
| Professional | | $1,464.62 | $1,689.95 | $1,971.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,523.40 / $1,523.40 / $1,523.40
| Professional | | $1,523.40 | $1,523.40 | $1,523.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,214.34 / $1,670.52 / $3,188.70
| Facility | | $1,214.34 | $1,670.52 | $3,188.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,214.34 / $1,734.38 / $2,847.76
| Professional | | $1,214.34 | $1,734.38 | $2,847.76 |
- 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
- $1,058.43 / $1,375.52 / $2,192.29
| Professional | | $1,058.43 | $1,375.52 | $2,192.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $961.54 / $1,103.95 / $1,503.13
| Professional | | $961.54 | $1,103.95 | $1,503.13 |