- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $658.71 / $3,964.00 / $8,451.00
| Facility | | $658.71 | $3,964.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.30 / $573.48 / $796.05
| Professional | | $441.30 | $573.48 | $796.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.60 / $626.37 / $626.37
| Professional | | $603.60 | $626.37 | $626.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.71 / $701.61 / $1,160.91
| Professional | | $470.71 | $701.61 | $1,160.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $718.87 / $951.10 / $974.68
| Professional | | $718.87 | $951.10 | $974.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,630.66 / $14,224.60 / $26,515.87
| Facility | | $11,630.66 | $14,224.60 | $26,515.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.00 / $4,761.00 / $8,404.00
| Facility | | $976.00 | $4,761.00 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.31 / $643.24 / $1,956.36
| Professional | | $454.31 | $643.24 | $1,956.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $586.40 / $1,610.90
| Professional | | $5.00 | $586.40 | $1,610.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.46 / $705.54 / $1,188.82
| Professional | | $503.46 | $705.54 | $1,188.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.88 / $450.02 / $593.55
| Facility | | $436.88 | $450.02 | $593.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.07 / $530.50 / $633.03
| Professional | | $439.07 | $530.50 | $633.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.59 / $729.20 / $1,231.07
| Professional | | $506.59 | $729.20 | $1,231.07 |