- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $895.00 / $3,682.00 / $12,941.00
| Facility | | $895.00 | $3,682.00 | $12,941.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,043.31 / $2,415.96 / $3,714.20
| Professional | | $2,043.31 | $2,415.96 | $3,714.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,504.90 / $4,192.06 / $9,471.92
| Facility | | $2,504.90 | $4,192.06 | $9,471.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,324.51 / $2,942.26 / $3,352.33
| Professional | | $2,324.51 | $2,942.26 | $3,352.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,339.05 / $2,339.05 / $2,339.05
| Facility | | $2,339.05 | $2,339.05 | $2,339.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,631.75 / $3,474.58 / $5,012.07
| Professional | | $2,631.75 | $3,474.58 | $5,012.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $33,736.44
| Facility | | $55.00 | $55.00 | $33,736.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17,488.43 / $17,676.64 / $22,515.83
| Professional | | $17,488.43 | $17,676.64 | $22,515.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,293.98 / $3,024.40 / $5,649.23
| Facility | | $2,293.98 | $3,024.40 | $5,649.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,719.83 / $3,783.03 / $4,450.63
| Professional | | $2,719.83 | $3,783.03 | $4,450.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,346.90 / $3,346.90 / $3,346.90
| Professional | | $3,346.90 | $3,346.90 | $3,346.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,293.98 / $3,032.61 / $5,782.46
| Facility | | $2,293.98 | $3,032.61 | $5,782.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,661.89 / $3,474.58 / $5,083.82
| Professional | | $2,661.89 | $3,474.58 | $5,083.82 |
- 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
- $1,990.44 / $2,711.21 / $4,349.80
| Professional | | $1,990.44 | $2,711.21 | $4,349.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,110.26 / $2,396.26 / $3,282.28
| Professional | | $2,110.26 | $2,396.26 | $3,282.28 |