- 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
- $2,650.11 / $2,974.12 / $4,383.12
| Professional | | $2,650.11 | $2,974.12 | $4,383.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,659.08 / $3,366.62 / $4,689.25
| Professional | | $2,659.08 | $3,366.62 | $4,689.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,622.42 / $2,622.42 / $2,728.73
| Facility | | $2,622.42 | $2,622.42 | $2,728.73 |
- 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
- $2,762.99 / $3,823.87 / $5,940.11
| Professional | | $2,762.99 | $3,823.87 | $5,940.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $29,190.33
| Facility | | $55.00 | $55.00 | $29,190.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20,316.80 / $20,821.75 / $24,869.40
| Professional | | $20,316.80 | $20,821.75 | $24,869.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,751.03 / $3,424.31 / $5,907.68
| Facility | | $2,751.03 | $3,424.31 | $5,907.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,233.29 / $4,301.68 / $5,060.81
| Professional | | $3,233.29 | $4,301.68 | $5,060.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,976.70 / $5,251.56 / $10,493.54
| Professional | | $2,976.70 | $5,251.56 | $10,493.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,751.03 / $3,446.74 / $6,599.71
| Facility | | $2,751.03 | $3,446.74 | $6,599.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,869.07 / $4,028.67 / $7,191.95
| Professional | | $2,869.07 | $4,028.67 | $7,191.95 |
- 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
- $2,307.48 / $3,177.07 / $5,004.34
| Professional | | $2,307.48 | $3,177.07 | $5,004.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,399.58 / $2,787.83 / $3,760.03
| Professional | | $2,399.58 | $2,787.83 | $3,760.03 |