- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,671.00 / $9,161.17 / $19,011.00
| Facility | | $3,671.00 | $9,161.17 | $19,011.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,344.83 / $9,334.11 / $10,307.07
| Professional | | $4,344.83 | $9,334.11 | $10,307.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,108.00 / $9,830.00 / $19,951.00
| Facility | | $4,108.00 | $9,830.00 | $19,951.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $930.36 / $11,504.18 / $18,429.03
| Professional | | $930.36 | $11,504.18 | $18,429.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.09 / $100.00 / $9,718.03
| Facility | | $66.09 | $100.00 | $9,718.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.08 / $698.68 / $1,336.09
| Professional | | $489.08 | $698.68 | $1,336.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,064.74 / $40,064.74 / $47,349.24
| Facility | | $40,064.74 | $40,064.74 | $47,349.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44,465.29 / $44,465.29 / $46,688.55
| Professional | | $44,465.29 | $44,465.29 | $46,688.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $628.80 / $768.55 / $1,187.76
| Professional | | $628.80 | $768.55 | $1,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,656.81 / $179,884.55 / $179,884.55
| Facility | | $7,656.81 | $179,884.55 | $179,884.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60,271.33 / $60,271.33 / $60,271.33
| Professional | | $60,271.33 | $60,271.33 | $60,271.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $698.68 / $873.35 / $13,643.73
| Facility | | $698.68 | $873.35 | $13,643.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $698.68 / $698.68 / $698.68
| Professional | | $698.68 | $698.68 | $698.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,830.00 / $18,515.00 / $48,543.00
| Facility | | $8,830.00 | $18,515.00 | $48,543.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,041.62 / $11,914.66 / $28,771.54
| Professional | | $8,041.62 | $11,914.66 | $28,771.54 |