- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $3,839.00 / $8,427.00
| Facility | | $1,020.00 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,365.69 / $1,579.14 / $1,980.66
| Professional | | $1,365.69 | $1,579.14 | $1,980.66 |
- 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
- $1,249.89 / $1,870.70 / $2,699.26
| Professional | | $1,249.89 | $1,870.70 | $2,699.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,393.16 / $1,810.26 / $2,878.61
| Professional | | $1,393.16 | $1,810.26 | $2,878.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,171.26 / $2,171.26 / $2,268.48
| Professional | | $2,171.26 | $2,171.26 | $2,268.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,427.00
| Facility | | $1,013.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,361.27 / $1,715.32 / $5,958.00
| Professional | | $1,361.27 | $1,715.32 | $5,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $2,171.80 / $3,546.70
| Professional | | $15.00 | $2,171.80 | $3,546.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,409.57 / $1,836.21 / $2,878.61
| Professional | | $1,409.57 | $1,836.21 | $2,878.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,389.50 / $1,389.50 / $1,636.48
| Facility | | $1,389.50 | $1,389.50 | $1,636.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,331.05 / $1,412.58 / $1,636.48
| Professional | | $1,331.05 | $1,412.58 | $1,636.48 |
- 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
- $1,333.73 / $1,779.95 / $2,908.92
| Professional | | $1,333.73 | $1,779.95 | $2,908.92 |