- 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
- $1,050.82 / $1,119.81 / $1,363.66
| Professional | | $1,050.82 | $1,119.81 | $1,363.66 |
- 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
- $858.51 / $1,273.82 / $1,855.21
| Professional | | $858.51 | $1,273.82 | $1,855.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $951.69 / $1,303.65 / $2,017.35
| Professional | | $951.69 | $1,303.65 | $2,017.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,475.27 / $1,475.27 / $1,564.63
| Professional | | $1,475.27 | $1,475.27 | $1,564.63 |
- 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
- $1,039.42 / $1,171.32 / $4,983.54
| Professional | | $1,039.42 | $1,171.32 | $4,983.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $1,661.00 / $2,394.60
| Professional | | $10.00 | $1,661.00 | $2,394.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,010.01 / $1,303.65 / $2,022.91
| Professional | | $1,010.01 | $1,303.65 | $2,022.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $951.58 / $951.58 / $1,232.19
| Facility | | $951.58 | $951.58 | $1,232.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $907.08 / $970.61 / $1,232.19
| Professional | | $907.08 | $970.61 | $1,232.19 |
- 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
- $955.62 / $1,297.24 / $2,058.69
| Professional | | $955.62 | $1,297.24 | $2,058.69 |