- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $867.00 / $3,219.00 / $10,893.00
| Facility | | $867.00 | $3,219.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,024.75 / $2,278.87 / $3,639.00
| Professional | | $2,024.75 | $2,278.87 | $3,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,151.04 / $3,709.74 / $11,266.31
| Facility | | $2,151.04 | $3,709.74 | $11,266.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,046.68 / $2,577.19 / $3,429.22
| Professional | | $2,046.68 | $2,577.19 | $3,429.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,026.92 / $2,026.92 / $2,103.76
| Facility | | $2,026.92 | $2,026.92 | $2,103.76 |
- 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
- $2,096.60 / $2,842.68 / $4,369.83
| Professional | | $2,096.60 | $2,842.68 | $4,369.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $17,409.34
| Facility | | $55.00 | $55.00 | $17,409.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17,183.28 / $17,183.28 / $19,053.23
| Professional | | $17,183.28 | $17,183.28 | $19,053.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.64 / $2,622.05 / $4,936.89
| Facility | | $2,097.64 | $2,622.05 | $4,936.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,477.79 / $3,296.54 / $3,878.28
| Professional | | $2,477.79 | $3,296.54 | $3,878.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $3,956.30 / $5,596.50
| Professional | | $6.00 | $3,956.30 | $5,596.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,100.46 / $2,640.45 / $5,062.97
| Facility | | $2,100.46 | $2,640.45 | $5,062.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,131.48 / $3,038.28 / $5,496.83
| Professional | | $2,131.48 | $3,038.28 | $5,496.83 |
- 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
- $1,759.64 / $2,351.92 / $3,836.00
| Professional | | $1,759.64 | $2,351.92 | $3,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,838.89 / $2,136.77 / $2,882.70
| Professional | | $1,838.89 | $2,136.77 | $2,882.70 |