- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,663.12 / $3,111.85 / $9,232.45
| Facility | | $2,663.12 | $3,111.85 | $9,232.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.40 / $683.74 / $2,321.37
| Professional | | $350.40 | $683.74 | $2,321.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.68 / $7,292.00 / $34,394.65
| Facility | | $1,191.68 | $7,292.00 | $34,394.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.08 / $859.64 / $7,286.89
| Professional | | $500.08 | $859.64 | $7,286.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $712.73 / $1,062.48 / $1,888.29
| Professional | | $712.73 | $1,062.48 | $1,888.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.59 / $1,061.92 / $6,679.00
| Facility | | $496.59 | $1,061.92 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $586.71 / $720.06 / $1,287.41
| Professional | | $586.71 | $720.06 | $1,287.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.69 / $1,253.38 / $2,036.74
| Professional | | $626.69 | $1,253.38 | $2,036.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,302.20 / $20,129.79 / $35,420.44
| Facility | | $4,302.20 | $20,129.79 | $35,420.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $786.22 / $799.10 / $819.38
| Professional | | $786.22 | $799.10 | $819.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,361.00 / $7,827.00 / $43,616.05
| Facility | | $2,361.00 | $7,827.00 | $43,616.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $665.00 / $1,024.30 / $7,286.89
| Professional | | $665.00 | $1,024.30 | $7,286.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,348.25 / $8,348.25 / $8,348.25
| Facility | | $8,348.25 | $8,348.25 | $8,348.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,540.00 / $7,157.00 / $37,606.00
| Facility | | $2,540.00 | $7,157.00 | $37,606.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $594.78 / $811.74 / $1,533.67
| Professional | | $594.78 | $811.74 | $1,533.67 |