- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $988.00 / $2,399.00 / $9,173.20
| Facility | | $988.00 | $2,399.00 | $9,173.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.37 / $398.00 / $10,158.00
| Professional | | $73.37 | $398.00 | $10,158.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.46 / $5,071.00 / $19,119.63
| Facility | | $189.46 | $5,071.00 | $19,119.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.98 / $6,920.09 / $18,265.83
| Professional | | $90.98 | $6,920.09 | $18,265.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.38 / $129.53 / $248.83
| Facility | | $101.38 | $129.53 | $248.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.13 / $541.38 / $9,135.08
| Professional | | $140.13 | $541.38 | $9,135.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.06 / $643.70 / $13,085.42
| Professional | | $134.06 | $643.70 | $13,085.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.04 / $177.58 / $6,679.00
| Facility | | $85.04 | $177.58 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,968.39 / $5,905.39 / $10,450.76
| Professional | | $4,968.39 | $5,905.39 | $10,450.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.68 / $4,817.31 / $11,070.18
| Professional | | $105.68 | $4,817.31 | $11,070.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $620.48 / $1,654.62 / $22,229.10
| Facility | | $620.48 | $1,654.62 | $22,229.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.47 / $183.34 / $244.61
| Professional | | $114.47 | $183.34 | $244.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $6,003.00 / $17,462.00
| Facility | | $55.00 | $6,003.00 | $17,462.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,599.42 / $11,246.43 / $29,730.28
| Professional | | $6,599.42 | $11,246.43 | $29,730.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,485.00 / $7,292.00 / $25,507.60
| Facility | | $2,485.00 | $7,292.00 | $25,507.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,133.59 / $9,532.50 / $19,215.90
| Professional | | $6,133.59 | $9,532.50 | $19,215.90 |