- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,369.57 / $8,255.06 / $22,692.60
| Facility | | $2,369.57 | $8,255.06 | $22,692.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,721.88 / $2,622.32 / $2,685.51
| Professional | | $1,721.88 | $2,622.32 | $2,685.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $15,828.69
| Facility | | $244.00 | $614.00 | $15,828.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.00 / $600.00 / $5,181.43
| Professional | | $500.00 | $600.00 | $5,181.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.00 / $4,770.72 / $8,688.40
| Facility | | $97.00 | $4,770.72 | $8,688.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,437.53 / $2,053.62 / $5,135.08
| Professional | | $1,437.53 | $2,053.62 | $5,135.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,115.69 / $3,655.44 / $7,988.58
| Facility | | $2,115.69 | $3,655.44 | $7,988.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,159.42 / $3,475.36 / $4,265.22
| Professional | | $3,159.42 | $3,475.36 | $4,265.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,843.48 / $3,633.33 / $6,034.49
| Professional | | $2,843.48 | $3,633.33 | $6,034.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,497.39 / $15,007.25 / $15,007.25
| Facility | | $5,497.39 | $15,007.25 | $15,007.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,733.91 / $15,733.91 / $23,695.65
| Professional | | $15,733.91 | $15,733.91 | $23,695.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,527.54 / $3,791.30 / $7,050.28
| Facility | | $2,527.54 | $3,791.30 | $7,050.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,159.42 / $3,475.36 / $4,739.13
| Professional | | $3,159.42 | $3,475.36 | $4,739.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,326.96 / $1,421.74 / $9,782.51
| Professional | | $1,326.96 | $1,421.74 | $9,782.51 |