- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $3,839.00 / $8,427.00
| Facility | | $1,020.00 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $883.07 / $1,068.36 / $1,345.06
| Professional | | $883.07 | $1,068.36 | $1,345.06 |
- 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
- $842.12 / $1,539.69 / $1,984.54
| Professional | | $842.12 | $1,539.69 | $1,984.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $968.16 / $1,374.01 / $1,992.77
| Professional | | $968.16 | $1,374.01 | $1,992.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,444.58 / $1,444.58 / $1,523.62
| Professional | | $1,444.58 | $1,444.58 | $1,523.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,427.00
| Facility | | $1,013.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $883.07 / $1,157.90 / $4,979.14
| Professional | | $883.07 | $1,157.90 | $4,979.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.00 / $1,724.10 / $2,372.50
| Professional | | $20.00 | $1,724.10 | $2,372.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,061.32 / $1,379.72 / $2,119.65
| Professional | | $1,061.32 | $1,379.72 | $2,119.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $935.33 / $939.98 / $939.98
| Facility | | $935.33 | $939.98 | $939.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $897.12 / $939.98 / $980.49
| Professional | | $897.12 | $939.98 | $980.49 |
- 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
- $955.76 / $1,274.20 / $1,993.10
| Professional | | $955.76 | $1,274.20 | $1,993.10 |