- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.00 / $3,748.00 / $8,017.00
| Facility | | $1,068.00 | $3,748.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $965.01 / $1,090.79 / $1,432.24
| Professional | | $965.01 | $1,090.79 | $1,432.24 |
- 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
- $940.34 / $1,512.97 / $2,033.37
| Professional | | $940.34 | $1,512.97 | $2,033.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,020.65 / $1,400.84 / $2,158.08
| Professional | | $1,020.65 | $1,400.84 | $2,158.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,255.83 / $1,665.61 / $1,665.61
| Professional | | $1,255.83 | $1,665.61 | $1,665.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,964.00 / $8,247.00
| Facility | | $832.00 | $3,964.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $975.26 / $1,145.68 / $5,596.47
| Professional | | $975.26 | $1,145.68 | $5,596.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $1,359.30 / $2,728.50
| Professional | | $5.00 | $1,359.30 | $2,728.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,036.51 / $1,407.12 / $2,378.38
| Professional | | $1,036.51 | $1,407.12 | $2,378.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,055.77 / $1,055.77 / $1,169.80
| Facility | | $1,055.77 | $1,055.77 | $1,169.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,024.03 / $1,060.24 / $1,169.80
| Professional | | $1,024.03 | $1,060.24 | $1,169.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,000.00
| Facility | | $2,155.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $918.15 / $1,283.90 / $2,132.66
| Professional | | $918.15 | $1,283.90 | $2,132.66 |