- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $728.87 / $9,697.00 / $21,960.90
| Facility | | $728.87 | $9,697.00 | $21,960.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $684.61 / $837.25 / $2,052.66
| Professional | | $684.61 | $837.25 | $2,052.66 |
- 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
- $836.39 / $1,096.24 / $2,080.03
| Professional | | $836.39 | $1,096.24 | $2,080.03 |
- 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
- $538.45 / $802.76 / $1,574.95
| Professional | | $538.45 | $802.76 | $1,574.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $775.60 / $963.75 / $2,042.04
| Professional | | $775.60 | $963.75 | $2,042.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $642.22 / $789.31 / $963.33
| Professional | | $642.22 | $789.31 | $963.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $710.38 / $918.80 / $1,931.47
| Professional | | $710.38 | $918.80 | $1,931.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $7,782.50 / $9,656.45
| Facility | | $55.00 | $7,782.50 | $9,656.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,373.28 / $5,521.36 / $6,503.63
| Professional | | $5,373.28 | $5,521.36 | $6,503.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.53 / $928.19 / $1,267.17
| Facility | | $735.53 | $928.19 | $1,267.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $781.31 / $965.36 / $2,078.06
| Professional | | $781.31 | $965.36 | $2,078.06 |
- 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
- $654.23 / $966.90 / $2,192.42
| Professional | | $654.23 | $966.90 | $2,192.42 |