- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.54 / $5,412.00 / $14,798.00
| Facility | | $105.54 | $5,412.00 | $14,798.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.80 / $1,532.57 / $2,635.90
| Professional | | $82.80 | $1,532.57 | $2,635.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.64 / $1,412.64 / $2,727.33
| Professional | | $83.64 | $1,412.64 | $2,727.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.93 / $73.93 / $1,757.02
| Professional | | $73.93 | $73.93 | $1,757.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.97 / $148.97 / $610.00
| Facility | | $148.97 | $148.97 | $610.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.76 / $271.05 / $3,741.96
| Professional | | $80.76 | $271.05 | $3,741.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,971.21 / $2,464.01 / $3,777.48
| Professional | | $1,971.21 | $2,464.01 | $3,777.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.41 / $1,494.21 / $3,717.17
| Facility | | $90.41 | $1,494.21 | $3,717.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,352.90 / $3,080.00 / $4,291.64
| Professional | | $2,352.90 | $3,080.00 | $4,291.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.01 / $97.00 / $202.13
| Facility | | $76.01 | $97.00 | $202.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,770.55 / $2,753.18 / $4,605.99
| Professional | | $1,770.55 | $2,753.18 | $4,605.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,150.00 / $11,074.00 / $21,538.00
| Facility | | $2,150.00 | $11,074.00 | $21,538.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,546.36 / $2,601.05 / $4,466.10
| Professional | | $1,546.36 | $2,601.05 | $4,466.10 |