- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $880.45 / $7,345.00 / $15,020.00
| Facility | | $880.45 | $7,345.00 | $15,020.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.31 / $3,991.00 / $8,032.33
| Professional | | $508.31 | $3,991.00 | $8,032.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,160.00 / $18,351.00 / $19,756.00
| Facility | | $14,160.00 | $18,351.00 | $19,756.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.61 / $597.75 / $997.88
| Professional | | $474.61 | $597.75 | $997.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.65 / $561.92 / $12,325.00
| Professional | | $541.65 | $561.92 | $12,325.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $862.72
| Facility | | $640.00 | $640.00 | $862.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.74 / $1,397.78 / $11,506.72
| Professional | | $538.74 | $1,397.78 | $11,506.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,242.07 / $6,783.85 / $8,017.28
| Professional | | $5,242.07 | $6,783.85 | $8,017.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.64 / $5,116.52 / $10,990.83
| Facility | | $584.64 | $5,116.52 | $10,990.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,419.00 / $8,997.00 / $13,687.34
| Professional | | $7,419.00 | $8,997.00 | $13,687.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.72 / $709.79 / $8,426.31
| Facility | | $516.72 | $709.79 | $8,426.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,446.13 / $9,159.04 / $14,211.06
| Professional | | $6,446.13 | $9,159.04 | $14,211.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,408.00 / $13,296.00 / $26,537.00
| Facility | | $7,408.00 | $13,296.00 | $26,537.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,410.42 / $8,827.74 / $13,623.15
| Professional | | $5,410.42 | $8,827.74 | $13,623.15 |