- 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
- $1,467.76 / $1,641.00 / $2,428.98
| Professional | | $1,467.76 | $1,641.00 | $2,428.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,567.67 / $2,671.38 / $8,427.00
| Facility | | $1,567.67 | $2,671.38 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,460.64 / $1,861.51 / $2,593.50
| Professional | | $1,460.64 | $1,861.51 | $2,593.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,462.18 / $1,462.18 / $1,517.75
| Facility | | $1,462.18 | $1,462.18 | $1,517.75 |
- 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
- $1,526.12 / $2,116.00 / $3,262.59
| Professional | | $1,526.12 | $2,116.00 | $3,262.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $14,419.04
| Facility | | $55.00 | $55.00 | $14,419.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,046.47 / $12,046.47 / $13,806.08
| Professional | | $12,046.47 | $12,046.47 | $13,806.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,519.94 / $1,900.09 / $3,435.11
| Facility | | $1,519.94 | $1,900.09 | $3,435.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,795.58 / $2,388.90 / $2,810.47
| Professional | | $1,795.58 | $2,388.90 | $2,810.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,864.60 / $3,019.92 / $5,866.41
| Professional | | $1,864.60 | $3,019.92 | $5,866.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,520.07 / $1,918.59 / $3,618.54
| Facility | | $1,520.07 | $1,918.59 | $3,618.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,592.21 / $2,220.21 / $3,984.83
| Professional | | $1,592.21 | $2,220.21 | $3,984.83 |
- 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
- $1,285.92 / $1,745.99 / $2,746.92
| Professional | | $1,285.92 | $1,745.99 | $2,746.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,332.58 / $1,548.48 / $2,089.06
| Professional | | $1,332.58 | $1,548.48 | $2,089.06 |