- 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
- $943.19 / $1,086.20 / $1,358.82
| Professional | | $943.19 | $1,086.20 | $1,358.82 |
- 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
- $973.61 / $1,010.35 / $1,559.90
| Professional | | $973.61 | $1,010.35 | $1,559.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $964.10 / $1,259.16 / $1,966.65
| Professional | | $964.10 | $1,259.16 | $1,966.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,494.14 / $1,494.14 / $1,568.72
| Professional | | $1,494.14 | $1,494.14 | $1,568.72 |
- 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
- $943.19 / $1,171.89 / $5,039.01
| Professional | | $943.19 | $1,171.89 | $5,039.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $1,613.30 / $2,425.19
| Professional | | $15.00 | $1,613.30 | $2,425.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $999.76 / $1,272.45 / $1,966.65
| Professional | | $999.76 | $1,272.45 | $1,966.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $952.32 / $952.32 / $1,341.26
| Facility | | $952.32 | $952.32 | $1,341.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $911.35 / $969.01 / $1,341.26
| Professional | | $911.35 | $969.01 | $1,341.26 |
- 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
- $927.32 / $1,257.38 / $1,955.53
| Professional | | $927.32 | $1,257.38 | $1,955.53 |