- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $945.00 / $3,570.00 / $10,893.00
| Facility | | $945.00 | $3,570.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,247.78 / $1,393.77 / $2,101.58
| Professional | | $1,247.78 | $1,393.77 | $2,101.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,342.29 / $2,269.60 / $9,333.73
| Facility | | $1,342.29 | $2,269.60 | $9,333.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,219.02 / $1,581.00 / $2,202.67
| Professional | | $1,219.02 | $1,581.00 | $2,202.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,242.65 / $1,242.65 / $1,290.64
| Facility | | $1,242.65 | $1,242.65 | $1,290.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,024.00 / $4,619.00
| Facility | | $900.00 | $2,024.00 | $4,619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,293.80 / $1,761.39 / $2,782.42
| Professional | | $1,293.80 | $1,761.39 | $2,782.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $12,245.28
| Facility | | $55.00 | $55.00 | $12,245.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9,845.53 / $9,845.53 / $11,727.45
| Professional | | $9,845.53 | $9,845.53 | $11,727.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,290.07 / $1,607.39 / $2,770.26
| Facility | | $1,290.07 | $1,607.39 | $2,770.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,525.14 / $2,029.10 / $2,387.17
| Professional | | $1,525.14 | $2,029.10 | $2,387.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $2,249.61 / $3,418.60
| Professional | | $7.00 | $2,249.61 | $3,418.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,290.18 / $1,615.68 / $3,083.61
| Facility | | $1,290.18 | $1,615.68 | $3,083.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,343.66 / $1,876.10 / $3,383.08
| Professional | | $1,343.66 | $1,876.10 | $3,383.08 |
- 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
- $1,084.30 / $1,484.21 / $2,337.98
| Professional | | $1,084.30 | $1,484.21 | $2,337.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,131.88 / $1,315.20 / $1,774.22
| Professional | | $1,131.88 | $1,315.20 | $1,774.22 |