- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,528.00 / $2,943.86 / $12,642.00
| Facility | | $2,528.00 | $2,943.86 | $12,642.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.42 / $1,422.40 / $10,428.75
| Professional | | $457.42 | $1,422.40 | $10,428.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.98 / $5,097.00 / $13,483.66
| Facility | | $762.98 | $5,097.00 | $13,483.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.04 / $9,246.24 / $22,938.43
| Professional | | $525.04 | $9,246.24 | $22,938.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.44 / $700.89 / $1,390.87
| Facility | | $545.44 | $700.89 | $1,390.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,032.05 / $3,032.05 / $37,490.33
| Professional | | $3,032.05 | $3,032.05 | $37,490.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $610.65 / $1,946.82 / $16,098.38
| Professional | | $610.65 | $1,946.82 | $16,098.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.08 / $994.56 / $6,679.00
| Facility | | $465.08 | $994.56 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,281.85 / $7,682.76 / $10,821.66
| Professional | | $6,281.85 | $7,682.76 | $10,821.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $642.04 / $5,577.87 / $14,568.74
| Professional | | $642.04 | $5,577.87 | $14,568.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,449.46 / $3,504.77 / $3,595.40
| Facility | | $1,449.46 | $3,504.77 | $3,595.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.07 / $743.52 / $1,339.55
| Professional | | $452.07 | $743.52 | $1,339.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,904.00 / $15,421.00
| Facility | | $55.00 | $5,904.00 | $15,421.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,040.21 / $13,179.15 / $52,335.24
| Professional | | $8,040.21 | $13,179.15 | $52,335.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $5,904.00 / $15,421.00
| Facility | | $2,386.00 | $5,904.00 | $15,421.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,359.02 / $12,002.10 / $19,494.88
| Professional | | $7,359.02 | $12,002.10 | $19,494.88 |