- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.78 / $6,827.70 / $14,112.00
| Facility | | $544.78 | $6,827.70 | $14,112.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.92 / $1,482.21 / $8,305.41
| Professional | | $473.92 | $1,482.21 | $8,305.41 |
- 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
- $442.47 / $557.27 / $930.30
| Professional | | $442.47 | $557.27 | $930.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $504.25 / $524.23 / $12,325.00
| Professional | | $504.25 | $524.23 | $12,325.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $805.44
| Facility | | $640.00 | $640.00 | $805.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.48 / $1,303.46 / $11,459.55
| Professional | | $501.48 | $1,303.46 | $11,459.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,220.01 / $6,755.31 / $7,983.55
| Professional | | $5,220.01 | $6,755.31 | $7,983.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.78 / $5,093.08 / $10,933.44
| Facility | | $544.78 | $5,093.08 | $10,933.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,385.00 / $8,945.00 / $13,622.17
| Professional | | $7,385.00 | $8,945.00 | $13,622.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.54 / $661.41 / $8,382.29
| Facility | | $482.54 | $661.41 | $8,382.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,412.46 / $9,111.20 / $14,142.10
| Professional | | $6,412.46 | $9,111.20 | $14,142.10 |
- 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
- $5,387.32 / $9,105.12 / $14,209.06
| Professional | | $5,387.32 | $9,105.12 | $14,209.06 |