- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.04 / $7,293.65 / $14,867.45
| Facility | | $618.04 | $7,293.65 | $14,867.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.10 / $3,226.00 / $7,407.88
| Professional | | $477.10 | $3,226.00 | $7,407.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,266.00 / $8,669.00 / $11,373.00
| Facility | | $6,266.00 | $8,669.00 | $11,373.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.56 / $1,694.87 / $6,975.85
| Professional | | $481.56 | $1,694.87 | $6,975.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.24 / $748.53 / $22,577.00
| Professional | | $540.24 | $748.53 | $22,577.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.54 / $1,403.92 / $11,026.37
| Professional | | $530.54 | $1,403.92 | $11,026.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,821.18 / $5,799.74 / $7,249.68
| Professional | | $4,821.18 | $5,799.74 | $7,249.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $610.34 / $4,821.18 / $10,044.51
| Facility | | $610.34 | $4,821.18 | $10,044.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,509.00 / $8,453.00 / $9,868.00
| Professional | | $6,509.00 | $8,453.00 | $9,868.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.84 / $688.28 / $24,191.00
| Facility | | $509.84 | $688.28 | $24,191.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,137.89 / $8,707.56 / $27,532.26
| Professional | | $6,137.89 | $8,707.56 | $27,532.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,341.00 / $40,200.00 / $81,661.00
| Facility | | $16,341.00 | $40,200.00 | $81,661.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,957.27 / $10,012.19 / $14,775.70
| Professional | | $5,957.27 | $10,012.19 | $14,775.70 |