- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,234.47 / $3,645.00 / $8,294.00
| Facility | | $1,234.47 | $3,645.00 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $965.13 / $1,157.28 / $1,584.48
| Professional | | $965.13 | $1,157.28 | $1,584.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $908.76 / $1,162.09 / $1,921.29
| Professional | | $908.76 | $1,162.09 | $1,921.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,105.49 / $1,217.81 / $5,113.00
| Professional | | $1,105.49 | $1,217.81 | $5,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.00 / $572.00 / $1,107.83
| Facility | | $572.00 | $572.00 | $1,107.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.51 / $1,352.11 / $2,222.69
| Professional | | $977.51 | $1,352.11 | $2,222.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $945.25 / $1,209.92 / $1,410.55
| Professional | | $945.25 | $1,209.92 | $1,410.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.98 / $1,414.73 / $2,035.98
| Facility | | $1,030.98 | $1,414.73 | $2,035.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,362.58 / $1,581.00 / $2,186.00
| Professional | | $1,362.58 | $1,581.00 | $2,186.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $950.09 / $1,341.96 / $4,465.39
| Facility | | $950.09 | $1,341.96 | $4,465.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $950.09 / $1,341.96 / $4,465.39
| Professional | | $950.09 | $1,341.96 | $4,465.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,423.00 / $11,475.00 / $21,639.00
| Facility | | $6,423.00 | $11,475.00 | $21,639.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $806.95 / $1,286.44 / $2,000.75
| Professional | | $806.95 | $1,286.44 | $2,000.75 |