- 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
- $1,461.40 / $1,690.12 / $2,082.23
| Professional | | $1,461.40 | $1,690.12 | $2,082.23 |
- 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
- $1,305.36 / $1,950.28 / $2,830.58
| Professional | | $1,305.36 | $1,950.28 | $2,830.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,444.87 / $1,975.86 / $3,065.99
| Professional | | $1,444.87 | $1,975.86 | $3,065.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,230.94 / $2,230.94 / $2,376.03
| Professional | | $2,230.94 | $2,230.94 | $2,376.03 |
- 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
- $1,426.00 / $1,780.79 / $5,958.00
| Professional | | $1,426.00 | $1,780.79 | $5,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $2,231.40 / $3,630.90
| Professional | | $10.00 | $2,231.40 | $3,630.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,535.73 / $1,975.86 / $3,065.99
| Professional | | $1,535.73 | $1,975.86 | $3,065.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,450.53 / $1,450.53 / $1,888.39
| Facility | | $1,450.53 | $1,450.53 | $1,888.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.03 / $1,479.54 / $1,888.39
| Professional | | $1,380.03 | $1,479.54 | $1,888.39 |
- 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
- $1,444.31 / $1,942.66 / $3,110.59
| Professional | | $1,444.31 | $1,942.66 | $3,110.59 |