- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,596.00 / $10,836.00
| Facility | | $969.00 | $3,596.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,782.12 / $2,111.90 / $3,241.41
| Professional | | $1,782.12 | $2,111.90 | $3,241.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,011.20 / $2,563.84 / $4,347.39
| Professional | | $2,011.20 | $2,563.84 | $4,347.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,057.46 / $2,057.46 / $2,057.46
| Facility | | $2,057.46 | $2,057.46 | $2,057.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,300.69 / $3,032.29 / $4,406.37
| Professional | | $2,300.69 | $3,032.29 | $4,406.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $39,300.16
| Facility | | $55.00 | $55.00 | $39,300.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,270.06 / $15,440.48 / $19,645.50
| Professional | | $15,270.06 | $15,440.48 | $19,645.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,074.14 / $2,739.78 / $4,916.53
| Facility | | $2,074.14 | $2,739.78 | $4,916.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,374.69 / $3,302.98 / $3,885.86
| Professional | | $2,374.69 | $3,302.98 | $3,885.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,880.20 / $2,880.20 / $2,880.20
| Professional | | $2,880.20 | $2,880.20 | $2,880.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,074.14 / $2,760.78 / $5,032.49
| Facility | | $2,074.14 | $2,760.78 | $5,032.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,317.19 / $3,032.29 / $4,524.96
| Professional | | $2,317.19 | $3,032.29 | $4,524.96 |
- 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
- $1,786.05 / $2,396.28 / $3,867.65
| Professional | | $1,786.05 | $2,396.28 | $3,867.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,842.48 / $2,091.23 / $2,866.97
| Professional | | $1,842.48 | $2,091.23 | $2,866.97 |