- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $916.17 / $10,004.00 / $21,960.90
| Facility | | $916.17 | $10,004.00 | $21,960.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $838.05 / $916.17 / $2,852.85
| Professional | | $838.05 | $916.17 | $2,852.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,540.00 / $15,357.00 / $37,532.26
| Facility | | $5,540.00 | $15,357.00 | $37,532.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,051.27 / $1,377.87 / $2,614.41
| Professional | | $1,051.27 | $1,377.87 | $2,614.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.00 / $100.00 / $5,485.17
| Facility | | $64.00 | $100.00 | $5,485.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.78 / $1,009.00 / $1,979.57
| Professional | | $676.78 | $1,009.00 | $1,979.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $974.85 / $1,211.33 / $2,566.63
| Professional | | $974.85 | $1,211.33 | $2,566.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $807.52 / $992.17 / $1,211.28
| Professional | | $807.52 | $992.17 | $1,211.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $892.95 / $1,154.98 / $2,101.63
| Professional | | $892.95 | $1,154.98 | $2,101.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $9,784.61 / $12,133.00
| Facility | | $55.00 | $9,784.61 | $12,133.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,754.24 / $6,937.52 / $8,177.70
| Professional | | $6,754.24 | $6,937.52 | $8,177.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.60 / $1,166.76 / $1,592.86
| Facility | | $924.60 | $1,166.76 | $1,592.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $982.04 / $1,213.31 / $2,611.92
| Professional | | $982.04 | $1,213.31 | $2,611.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,930.00 / $6,395.00 / $18,709.00
| Facility | | $1,930.00 | $6,395.00 | $18,709.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $822.26 / $1,215.24 / $2,564.53
| Professional | | $822.26 | $1,215.24 | $2,564.53 |