- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,084.00 / $3,748.00 / $8,017.00
| Facility | | $1,084.00 | $3,748.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.91 / $1,095.57 / $1,405.60
| Professional | | $750.91 | $1,095.57 | $1,405.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,042.38 / $1,081.72 / $1,081.72
| Professional | | $1,042.38 | $1,081.72 | $1,081.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $873.72 / $1,219.98 / $2,008.38
| Professional | | $873.72 | $1,219.98 | $2,008.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,270.06 / $1,687.99 / $1,715.63
| Professional | | $1,270.06 | $1,687.99 | $1,715.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,421.46 / $10,421.46 / $26,515.87
| Facility | | $10,421.46 | $10,421.46 | $26,515.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,068.00 / $8,017.00
| Facility | | $1,013.00 | $4,068.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.91 / $1,119.00 / $3,823.41
| Professional | | $750.91 | $1,119.00 | $3,823.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $689.90 / $2,919.20
| Professional | | $5.00 | $689.90 | $2,919.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $930.65 / $1,270.04 / $2,029.05
| Professional | | $930.65 | $1,270.04 | $2,029.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $862.98 / $1,049.61 / $1,049.61
| Facility | | $862.98 | $1,049.61 | $1,049.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $862.98 / $1,049.61 / $1,131.57
| Professional | | $862.98 | $1,049.61 | $1,131.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $775.45 / $1,183.32 / $2,140.26
| Professional | | $775.45 | $1,183.32 | $2,140.26 |