- 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
- $2,336.55 / $2,622.13 / $3,886.49
| Professional | | $2,336.55 | $2,622.13 | $3,886.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,308.34 / $2,932.81 / $4,096.42
| Professional | | $2,308.34 | $2,932.81 | $4,096.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,285.57 / $2,285.57 / $2,377.21
| Facility | | $2,285.57 | $2,285.57 | $2,377.21 |
- 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
- $2,434.52 / $3,379.40 / $5,227.27
| Professional | | $2,434.52 | $3,379.40 | $5,227.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $45,948.32
| Facility | | $55.00 | $55.00 | $45,948.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18,006.88 / $18,414.96 / $21,981.53
| Professional | | $18,006.88 | $18,414.96 | $21,981.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,427.90 / $3,036.84 / $5,277.77
| Facility | | $2,427.90 | $3,036.84 | $5,277.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,861.68 / $3,807.28 / $4,479.16
| Professional | | $2,861.68 | $3,807.28 | $4,479.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,273.92 / $2,715.86 / $4,933.89
| Professional | | $2,273.92 | $2,715.86 | $4,933.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,431.15 / $3,053.87 / $5,795.77
| Facility | | $2,431.15 | $3,053.87 | $5,795.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,525.06 / $3,571.84 / $6,327.74
| Professional | | $2,525.06 | $3,571.84 | $6,327.74 |
- 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
- $2,110.39 / $2,818.18 / $4,388.31
| Professional | | $2,110.39 | $2,818.18 | $4,388.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,123.79 / $2,467.98 / $3,328.37
| Professional | | $2,123.79 | $2,467.98 | $3,328.37 |