- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,024.33 / $2,747.00 / $8,017.00
| Facility | | $1,024.33 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $863.46 / $1,024.33 / $1,332.13
| Professional | | $863.46 | $1,024.33 | $1,332.13 |
- 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
- $1,002.16 / $1,039.97 / $1,621.75
| Professional | | $1,002.16 | $1,039.97 | $1,621.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $930.50 / $1,262.64 / $2,049.39
| Professional | | $930.50 | $1,262.64 | $2,049.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,200.77 / $1,593.01 / $1,613.39
| Professional | | $1,200.77 | $1,593.01 | $1,613.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,120.00 / $8,017.00
| Facility | | $954.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $877.79 / $1,093.14 / $2,729.31
| Professional | | $877.79 | $1,093.14 | $2,729.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,155.90 / $2,657.00
| Professional | | $6.00 | $1,155.90 | $2,657.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $968.92 / $1,290.48 / $2,059.11
| Professional | | $968.92 | $1,290.48 | $2,059.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $958.91 / $990.08 / $990.08
| Facility | | $958.91 | $990.08 | $990.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $958.91 / $990.08 / $1,055.94
| Professional | | $958.91 | $990.08 | $1,055.94 |
- 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
- $850.86 / $1,219.03 / $1,925.44
| Professional | | $850.86 | $1,219.03 | $1,925.44 |