- 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
- $2,227.10 / $2,570.37 / $3,087.76
| Professional | | $2,227.10 | $2,570.37 | $3,087.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,093.96 / $2,650.45 / $3,692.67
| Professional | | $2,093.96 | $2,650.45 | $3,692.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,080.63 / $2,080.63 / $2,080.63
| Facility | | $2,080.63 | $2,080.63 | $2,080.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,389.69 / $3,154.52 / $4,858.43
| Professional | | $2,389.69 | $3,154.52 | $4,858.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $40,708.16
| Facility | | $55.00 | $55.00 | $40,708.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23,688.62 / $23,688.62 / $23,688.62
| Professional | | $23,688.62 | $23,688.62 | $23,688.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,280.48 / $2,923.25 / $5,279.06
| Facility | | $2,280.48 | $2,923.25 | $5,279.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,878.36 / $3,321.18 / $3,874.71
| Professional | | $2,878.36 | $3,321.18 | $3,874.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,416.15 / $3,780.82 / $8,267.37
| Professional | | $2,416.15 | $3,780.82 | $8,267.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,280.48 / $3,010.81 / $6,321.40
| Facility | | $2,280.48 | $3,010.81 | $6,321.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,389.08 / $3,229.32 / $5,610.76
| Professional | | $2,389.08 | $3,229.32 | $5,610.76 |
- 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
- $1,978.27 / $2,697.12 / $4,118.14
| Professional | | $1,978.27 | $2,697.12 | $4,118.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,889.68 / $2,171.89 / $2,952.41
| Professional | | $1,889.68 | $2,171.89 | $2,952.41 |