- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,570.00 / $10,836.00
| Facility | | $969.00 | $3,570.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,032.10 / $1,147.96 / $1,541.27
| Professional | | $1,032.10 | $1,147.96 | $1,541.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $995.43 / $1,264.82 / $1,755.42
| Professional | | $995.43 | $1,264.82 | $1,755.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.46 / $926.46 / $926.46
| Facility | | $926.46 | $926.46 | $926.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,093.09 / $1,421.03 / $2,205.44
| Professional | | $1,093.09 | $1,421.03 | $2,205.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $8,541.26
| Facility | | $55.00 | $55.00 | $8,541.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,730.16 / $7,980.88 / $9,059.48
| Professional | | $7,730.16 | $7,980.88 | $9,059.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.66 / $1,370.59 / $2,256.17
| Facility | | $1,068.66 | $1,370.59 | $2,256.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,149.63 / $1,599.03 / $1,881.22
| Professional | | $1,149.63 | $1,599.03 | $1,881.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,385.60 / $1,385.60 / $1,385.60
| Professional | | $1,385.60 | $1,385.60 | $1,385.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.66 / $1,372.27 / $2,602.94
| Facility | | $1,068.66 | $1,372.27 | $2,602.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,108.58 / $1,428.68 / $2,303.23
| Professional | | $1,108.58 | $1,428.68 | $2,303.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $887.22 / $1,170.65 / $1,885.35
| Professional | | $887.22 | $1,170.65 | $1,885.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.98 / $1,017.77 / $1,407.16
| Professional | | $891.98 | $1,017.77 | $1,407.16 |