- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $5,541.90 / $12,474.00
| Facility | | $1,013.00 | $5,541.90 | $12,474.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.06 / $1,647.53 / $6,371.40
| Professional | | $283.06 | $1,647.53 | $6,371.40 |
- 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
- $3,346.42 / $6,767.65 / $9,721.15
| Professional | | $3,346.42 | $6,767.65 | $9,721.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.90 / $708.71 / $8,000.80
| Professional | | $333.90 | $708.71 | $8,000.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,240.86 / $6,240.86 / $6,494.62
| Professional | | $6,240.86 | $6,240.86 | $6,494.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,922.32 / $21,922.32 / $21,922.32
| Facility | | $21,922.32 | $21,922.32 | $21,922.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,278.00 / $6,190.00 / $12,474.00
| Facility | | $1,278.00 | $6,190.00 | $12,474.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.05 / $1,647.53 / $7,791.16
| Professional | | $308.05 | $1,647.53 | $7,791.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.14 / $624.28 / $7,499.58
| Professional | | $312.14 | $624.28 | $7,499.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.38 / $708.71 / $8,000.80
| Professional | | $340.38 | $708.71 | $8,000.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.54 / $334.41 / $5,830.57
| Facility | | $303.54 | $334.41 | $5,830.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.54 / $334.41 / $4,485.85
| Professional | | $303.54 | $334.41 | $4,485.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $7,000.00 / $12,076.00
| Facility | | $3,340.00 | $7,000.00 | $12,076.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,752.89 / $6,452.67 / $11,080.72
| Professional | | $4,752.89 | $6,452.67 | $11,080.72 |