- 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
- $2,123.23 / $2,429.75 / $2,930.96
| Professional | | $2,123.23 | $2,429.75 | $2,930.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,994.24 / $2,482.62 / $3,499.96
| Professional | | $1,994.24 | $2,482.62 | $3,499.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,931.31 / $1,931.31 / $1,931.31
| Facility | | $1,931.31 | $1,931.31 | $1,931.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,239.07 / $2,996.36 / $4,675.57
| Professional | | $2,239.07 | $2,996.36 | $4,675.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $37,772.16
| Facility | | $55.00 | $55.00 | $37,772.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,818.64 / $15,560.08 / $18,172.95
| Professional | | $14,818.64 | $15,560.08 | $18,172.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,205.10 / $2,823.03 / $4,965.42
| Facility | | $2,205.10 | $2,823.03 | $4,965.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,670.63 / $3,081.50 / $3,595.08
| Professional | | $2,670.63 | $3,081.50 | $3,595.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,422.80 / $2,547.57 / $2,867.30
| Professional | | $2,422.80 | $2,547.57 | $2,867.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,205.10 / $2,849.47 / $5,560.49
| Facility | | $2,205.10 | $2,849.47 | $5,560.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,217.05 / $3,064.46 / $5,210.38
| Professional | | $2,217.05 | $3,064.46 | $5,210.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.00 / $2,547.00 / $9,000.00
| Facility | | $495.00 | $2,547.00 | $9,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,877.82 / $2,449.02 / $3,942.36
| Professional | | $1,877.82 | $2,449.02 | $3,942.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,753.31 / $2,015.12 / $2,739.41
| Professional | | $1,753.31 | $2,015.12 | $2,739.41 |