- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,918.45 / $13,651.00 / $37,525.69
| Facility | | $3,918.45 | $13,651.00 | $37,525.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,847.41 / $4,336.42 / $4,440.91
| Professional | | $2,847.41 | $4,336.42 | $4,440.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $26,175.25
| Facility | | $244.00 | $614.00 | $26,175.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.20 / $79.44 / $8,568.34
| Professional | | $66.20 | $79.44 | $8,568.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $6,896.47 / $46,864.66
| Facility | | $59.40 | $6,896.47 | $46,864.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,377.19 / $3,395.99 / $8,491.67
| Professional | | $2,377.19 | $3,395.99 | $8,491.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,446.93 / $6,724.06 / $13,210.40
| Facility | | $3,446.93 | $6,724.06 | $13,210.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,224.60 / $5,747.06 / $7,053.21
| Professional | | $5,224.60 | $5,747.06 | $7,053.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,702.14 / $6,008.29 / $11,389.63
| Professional | | $4,702.14 | $6,008.29 | $11,389.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,090.79 / $24,816.85 / $24,816.85
| Facility | | $9,090.79 | $24,816.85 | $24,816.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26,018.51 / $26,018.51 / $39,184.50
| Professional | | $26,018.51 | $26,018.51 | $39,184.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,179.68 / $6,269.52 / $11,658.77
| Facility | | $4,179.68 | $6,269.52 | $11,658.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,224.60 / $5,747.06 / $7,836.90
| Professional | | $5,224.60 | $5,747.06 | $7,836.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,194.33 / $2,282.98 / $14,318.02
| Professional | | $2,194.33 | $2,282.98 | $14,318.02 |