- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $3,839.00 / $8,247.00
| Facility | | $1,020.00 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $963.06 / $1,109.33 / $1,384.98
| Professional | | $963.06 | $1,109.33 | $1,384.98 |
- 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
- $995.72 / $1,033.30 / $1,033.30
| Professional | | $995.72 | $1,033.30 | $1,033.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $973.25 / $1,268.13 / $1,993.98
| Professional | | $973.25 | $1,268.13 | $1,993.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,535.88 / $1,535.88 / $1,605.59
| Professional | | $1,535.88 | $1,535.88 | $1,605.59 |
- 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
- $963.06 / $1,197.78 / $2,843.00
| Professional | | $963.06 | $1,197.78 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $1,590.10 / $2,488.40
| Professional | | $15.00 | $1,590.10 | $2,488.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $986.33 / $1,284.39 / $1,993.98
| Professional | | $986.33 | $1,284.39 | $1,993.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $972.24 / $972.24 / $1,000.41
| Facility | | $972.24 | $972.24 | $1,000.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $931.87 / $987.77 / $1,021.99
| Professional | | $931.87 | $987.77 | $1,021.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.00 / $2,391.00 / $6,322.00
| Facility | | $656.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $934.90 / $1,213.98 / $2,047.11
| Professional | | $934.90 | $1,213.98 | $2,047.11 |