- 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
- $896.45 / $1,152.82 / $1,443.66
| Professional | | $896.45 | $1,152.82 | $1,443.66 |
- 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
- $907.02 / $1,349.20 / $1,960.03
| Professional | | $907.02 | $1,349.20 | $1,960.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $995.82 / $1,309.59 / $2,077.48
| Professional | | $995.82 | $1,309.59 | $2,077.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,554.82 / $1,554.82 / $1,652.64
| Professional | | $1,554.82 | $1,554.82 | $1,652.64 |
- 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
- $896.45 / $1,237.94 / $5,270.88
| Professional | | $896.45 | $1,237.94 | $5,270.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.00 / $1,753.90 / $2,527.00
| Professional | | $8.00 | $1,753.90 | $2,527.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,018.58 / $1,317.56 / $2,077.48
| Professional | | $1,018.58 | $1,317.56 | $2,077.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,006.63 / $1,006.63 / $1,265.02
| Facility | | $1,006.63 | $1,006.63 | $1,265.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $958.58 / $1,026.76 / $1,265.02
| Professional | | $958.58 | $1,026.76 | $1,265.02 |
- 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
- $929.48 / $1,243.67 / $2,077.17
| Professional | | $929.48 | $1,243.67 | $2,077.17 |