- 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
- $1,667.41 / $1,860.81 / $2,819.18
| Professional | | $1,667.41 | $1,860.81 | $2,819.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,667.35 / $2,111.01 / $2,940.35
| Professional | | $1,667.35 | $2,111.01 | $2,940.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,649.29 / $1,649.29 / $1,716.19
| Facility | | $1,649.29 | $1,649.29 | $1,716.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,068.42 / $4,619.00
| Facility | | $900.00 | $2,068.42 | $4,619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,728.96 / $2,368.42 / $3,711.71
| Professional | | $1,728.96 | $2,368.42 | $3,711.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $16,324.80
| Facility | | $55.00 | $55.00 | $16,324.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,782.16 / $13,073.44 / $15,648.90
| Professional | | $12,782.16 | $13,073.44 | $15,648.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,720.34 / $2,126.13 / $3,696.17
| Facility | | $1,720.34 | $2,126.13 | $3,696.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,034.38 / $2,706.62 / $3,184.25
| Professional | | $2,034.38 | $2,706.62 | $3,184.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,852.47 / $3,410.46 / $6,641.33
| Professional | | $1,852.47 | $3,410.46 | $6,641.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,721.99 / $2,155.76 / $4,129.99
| Facility | | $1,721.99 | $2,155.76 | $4,129.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,793.52 / $2,522.55 / $4,515.20
| Professional | | $1,793.52 | $2,522.55 | $4,515.20 |
- 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
- $1,440.20 / $1,992.80 / $3,129.11
| Professional | | $1,440.20 | $1,992.80 | $3,129.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,509.81 / $1,754.06 / $2,365.73
| Professional | | $1,509.81 | $1,754.06 | $2,365.73 |