- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,051.00 / $9,332.24
| Facility | | $1,020.00 | $4,051.00 | $9,332.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $805.74 / $908.16 / $1,319.98
| Professional | | $805.74 | $908.16 | $1,319.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $902.70 / $961.02 / $1,637.31
| Professional | | $902.70 | $961.02 | $1,637.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,048.16 / $2,246.29 / $2,828.78
| Professional | | $1,048.16 | $2,246.29 | $2,828.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,066.18 / $1,446.07 / $1,841.58
| Professional | | $1,066.18 | $1,446.07 | $1,841.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,151.00 / $5,350.00 / $10,247.00
| Facility | | $1,151.00 | $5,350.00 | $10,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $805.74 / $1,003.81 / $4,418.35
| Professional | | $805.74 | $1,003.81 | $4,418.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,120.50 / $1,120.50 / $1,839.10
| Professional | | $1,120.50 | $1,120.50 | $1,839.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,048.16 / $2,246.29 / $2,828.78
| Professional | | $1,048.16 | $2,246.29 | $2,828.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $878.11 / $878.11 / $967.02
| Facility | | $878.11 | $878.11 | $967.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $849.85 / $883.49 / $967.02
| Professional | | $849.85 | $883.49 | $967.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,228.00 / $4,563.00 / $8,261.00
| Facility | | $2,228.00 | $4,563.00 | $8,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $841.26 / $1,080.00 / $1,701.77
| Professional | | $841.26 | $1,080.00 | $1,701.77 |