- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $945.00 / $3,682.00 / $10,893.00
| Facility | | $945.00 | $3,682.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,273.91 / $3,687.77 / $5,579.89
| Professional | | $3,273.91 | $3,687.77 | $5,579.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,285.10 / $3,285.10 / $3,430.15
| Facility | | $3,285.10 | $3,285.10 | $3,430.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,277.00 / $4,619.00
| Facility | | $900.00 | $2,277.00 | $4,619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,987.24 / $4,696.85 / $7,361.60
| Professional | | $2,987.24 | $4,696.85 | $7,361.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $63,756.48
| Facility | | $55.00 | $55.00 | $63,756.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25,007.84 / $25,664.16 / $30,551.78
| Professional | | $25,007.84 | $25,664.16 | $30,551.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,609.02 / $3,953.17 / $7,782.18
| Facility | | $2,609.02 | $3,953.17 | $7,782.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,977.26 / $5,291.49 / $6,225.28
| Professional | | $3,977.26 | $5,291.49 | $6,225.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,244.85 / $3,811.33 / $7,119.53
| Professional | | $3,244.85 | $3,811.33 | $7,119.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,609.02 / $3,980.40 / $8,219.50
| Facility | | $2,609.02 | $3,980.40 | $8,219.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,371.02 / $5,032.35 / $8,884.44
| Professional | | $3,371.02 | $5,032.35 | $8,884.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $1,970.00 / $8,583.00
| Facility | | $385.00 | $1,970.00 | $8,583.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,887.26 / $3,884.43 / $6,219.79
| Professional | | $2,887.26 | $3,884.43 | $6,219.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,951.72 / $3,428.82 / $4,620.20
| Professional | | $2,951.72 | $3,428.82 | $4,620.20 |