- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,839.00 / $8,247.00
| Facility | | $1,013.00 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $878.15 / $1,009.03 / $1,334.98
| Professional | | $878.15 | $1,009.03 | $1,334.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $994.69 / $1,032.23 / $1,521.55
| Professional | | $994.69 | $1,032.23 | $1,521.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $961.73 / $1,299.70 / $2,060.34
| Professional | | $961.73 | $1,299.70 | $2,060.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,197.65 / $1,603.88 / $1,603.88
| Professional | | $1,197.65 | $1,603.88 | $1,603.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $878.15 / $1,028.81 / $2,843.00
| Professional | | $878.15 | $1,028.81 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $1,294.40 / $2,486.90
| Professional | | $15.00 | $1,294.40 | $2,486.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.17 / $1,299.94 / $2,128.73
| Professional | | $977.17 | $1,299.94 | $2,128.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $965.24 / $971.86 / $971.86
| Facility | | $965.24 | $971.86 | $971.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $931.26 / $971.86 / $1,021.66
| Professional | | $931.26 | $971.86 | $1,021.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $883.26 / $1,176.13 / $2,022.44
| Professional | | $883.26 | $1,176.13 | $2,022.44 |