- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,116.00 / $8,535.66 / $11,318.30
| Facility | | $3,116.00 | $8,535.66 | $11,318.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.58 / $320.58 / $4,798.64
| Professional | | $320.58 | $320.58 | $4,798.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,302.28 / $2,647.62 / $7,482.41
| Facility | | $2,302.28 | $2,647.62 | $7,482.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,869.60 / $1,875.44 / $15,580.00
| Professional | | $1,869.60 | $1,875.44 | $15,580.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,952.71 / $7,082.38 / $12,381.78
| Facility | | $4,952.71 | $7,082.38 | $12,381.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,866.72 / $2,866.72 / $2,866.72
| Professional | | $2,866.72 | $2,866.72 | $2,866.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,025.40 / $2,430.48 / $7,088.90
| Facility | | $2,025.40 | $2,430.48 | $7,088.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,830.22 / $2,991.29 / $8,122.95
| Professional | | $1,830.22 | $2,991.29 | $8,122.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,496.17 / $4,496.17 / $5,289.62
| Professional | | $4,496.17 | $4,496.17 | $5,289.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,116.00 / $3,116.00 / $9,649.94
| Professional | | $3,116.00 | $3,116.00 | $9,649.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,421.84 / $14,801.00 / $14,801.00
| Facility | | $5,421.84 | $14,801.00 | $14,801.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,869.60 / $1,875.44 / $15,580.00
| Professional | | $1,869.60 | $1,875.44 | $15,580.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,869.60 / $1,875.44 / $5,565.36
| Professional | | $1,869.60 | $1,875.44 | $5,565.36 |