- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,310.11 / $10,061.00 / $20,509.00
| Facility | | $2,310.11 | $10,061.00 | $20,509.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,100.92 / $2,416.06 / $11,896.20
| Professional | | $2,100.92 | $2,416.06 | $11,896.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,294.00 / $14,348.00 / $32,242.00
| Facility | | $4,294.00 | $14,348.00 | $32,242.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,035.65 / $4,057.77 / $7,823.39
| Professional | | $3,035.65 | $4,057.77 | $7,823.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.50 / $100.00 / $10,378.59
| Facility | | $63.50 | $100.00 | $10,378.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,481.94 / $2,279.12 / $5,078.34
| Professional | | $1,481.94 | $2,279.12 | $5,078.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,241.83 / $2,832.71 / $6,988.23
| Professional | | $2,241.83 | $2,832.71 | $6,988.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,458.67 / $1,839.50 / $2,855.71
| Professional | | $1,458.67 | $1,839.50 | $2,855.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,141.75 / $2,765.54 / $5,022.89
| Professional | | $2,141.75 | $2,765.54 | $5,022.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $44,376.15 / $55,050.24
| Facility | | $55.00 | $44,376.15 | $55,050.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21,137.00 / $22,658.53 / $22,658.53
| Professional | | $21,137.00 | $22,658.53 | $22,658.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,255.42 / $2,973.32 / $4,166.14
| Facility | | $2,255.42 | $2,973.32 | $4,166.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,241.83 / $2,800.71 / $6,398.95
| Professional | | $2,241.83 | $2,800.71 | $6,398.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,381.37 / $7,381.37 / $7,381.37
| Professional | | $7,381.37 | $7,381.37 | $7,381.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,458.67 / $2,188.01 / $2,759.25
| Professional | | $1,458.67 | $2,188.01 | $2,759.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,047.00 / $5,319.00 / $20,279.00
| Facility | | $2,047.00 | $5,319.00 | $20,279.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,941.19 / $2,747.53 / $5,835.67
| Professional | | $1,941.19 | $2,747.53 | $5,835.67 |