- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $880.00 / $3,219.00 / $10,893.00
| Facility | | $880.00 | $3,219.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,027.09 / $1,101.76 / $1,538.22
| Professional | | $1,027.09 | $1,101.76 | $1,538.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,122.95 / $7,324.30 / $14,454.58
| Facility | | $4,122.95 | $7,324.30 | $14,454.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $985.88 / $1,220.66 / $1,373.85
| Professional | | $985.88 | $1,220.66 | $1,373.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $940.08 / $940.08 / $957.50
| Facility | | $940.08 | $940.08 | $957.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,046.15 / $1,344.33 / $1,951.39
| Professional | | $1,046.15 | $1,344.33 | $1,951.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $26,542.00 / $26,542.00
| Facility | | $11,500.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,006.77 / $9,006.77 / $9,195.15
| Professional | | $9,006.77 | $9,006.77 | $9,195.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,012.18 / $1,233.15 / $1,817.81
| Facility | | $1,012.18 | $1,233.15 | $1,817.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,056.44 / $1,690.30 / $2,112.88
| Professional | | $1,056.44 | $1,690.30 | $2,112.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,012.18 / $1,256.50 / $1,949.00
| Facility | | $1,012.18 | $1,256.50 | $1,949.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,046.15 / $1,400.83 / $2,178.09
| Professional | | $1,046.15 | $1,400.83 | $2,178.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $13,237.00
| Facility | | $2,093.00 | $6,000.00 | $13,237.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.54 / $1,135.38 / $1,726.91
| Professional | | $851.54 | $1,135.38 | $1,726.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $901.64 / $1,025.48 / $1,422.48
| Professional | | $901.64 | $1,025.48 | $1,422.48 |