- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,682.00 / $10,836.00
| Facility | | $969.00 | $3,682.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,733.72 / $3,106.79 / $4,735.22
| Professional | | $2,733.72 | $3,106.79 | $4,735.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,607.28 / $4,199.75 / $6,564.23
| Professional | | $2,607.28 | $4,199.75 | $6,564.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,148.97 / $3,148.97 / $3,148.97
| Facility | | $3,148.97 | $3,148.97 | $3,148.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,424.23 / $4,407.30 / $6,522.38
| Professional | | $3,424.23 | $4,407.30 | $6,522.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $43,952.64
| Facility | | $55.00 | $55.00 | $43,952.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22,545.84 / $23,227.76 / $29,095.13
| Professional | | $22,545.84 | $23,227.76 | $29,095.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.45 / $3,809.34 / $7,272.79
| Facility | | $2,951.45 | $3,809.34 | $7,272.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,529.30 / $4,908.93 / $5,775.21
| Professional | | $3,529.30 | $4,908.93 | $5,775.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,588.50 / $3,588.50 / $3,588.50
| Professional | | $3,588.50 | $3,588.50 | $3,588.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,960.09 / $3,865.16 / $7,444.32
| Facility | | $2,960.09 | $3,865.16 | $7,444.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,439.86 / $4,436.83 / $6,663.63
| Professional | | $3,439.86 | $4,436.83 | $6,663.63 |
- 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
- $2,590.94 / $3,547.21 / $5,770.80
| Professional | | $2,590.94 | $3,547.21 | $5,770.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,738.32 / $3,101.49 / $4,269.82
| Professional | | $2,738.32 | $3,101.49 | $4,269.82 |