- 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
- $957.01 / $1,046.65 / $1,263.79
| Professional | | $957.01 | $1,046.65 | $1,263.79 |
- 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
- $793.66 / $1,244.50 / $1,718.97
| Professional | | $793.66 | $1,244.50 | $1,718.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $879.16 / $1,158.01 / $1,861.18
| Professional | | $879.16 | $1,158.01 | $1,861.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,359.77 / $1,359.77 / $1,445.60
| Professional | | $1,359.77 | $1,359.77 | $1,445.60 |
- 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
- $934.16 / $1,083.50 / $4,617.31
| Professional | | $934.16 | $1,083.50 | $4,617.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $1,304.70 / $2,210.60
| Professional | | $10.00 | $1,304.70 | $2,210.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $926.47 / $1,177.24 / $1,818.31
| Professional | | $926.47 | $1,177.24 | $1,818.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $881.12 / $881.12 / $988.67
| Facility | | $881.12 | $881.12 | $988.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $838.98 / $898.74 / $988.67
| Professional | | $838.98 | $898.74 | $988.67 |
- 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
- $850.78 / $1,177.96 / $1,860.58
| Professional | | $850.78 | $1,177.96 | $1,860.58 |