- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,335.09 / $5,165.00 / $16,713.00
| Facility | | $1,335.09 | $5,165.00 | $16,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.71 / $1,250.63 / $1,899.21
| Professional | | $235.71 | $1,250.63 | $1,899.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.00 / $5,863.00 / $11,456.00
| Facility | | $2,137.00 | $5,863.00 | $11,456.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.19 / $2,317.17 / $4,311.32
| Professional | | $402.19 | $2,317.17 | $4,311.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.40 / $100.00 / $8,389.08
| Facility | | $64.40 | $100.00 | $8,389.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.62 / $913.88 / $3,082.72
| Professional | | $232.62 | $913.88 | $3,082.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.37 / $1,033.53 / $2,872.04
| Professional | | $256.37 | $1,033.53 | $2,872.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.83 / $1,762.12 / $2,247.96
| Professional | | $243.83 | $1,762.12 | $2,247.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.94 / $817.25 / $1,983.50
| Professional | | $233.94 | $817.25 | $1,983.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,101.16 / $2,101.16
| Facility | | $55.00 | $2,101.16 | $2,101.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,266.53 / $9,842.37 / $11,157.78
| Professional | | $4,266.53 | $9,842.37 | $11,157.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.58 / $1,196.16 / $2,378.96
| Facility | | $267.58 | $1,196.16 | $2,378.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.49 / $784.47 / $3,322.65
| Professional | | $257.49 | $784.47 | $3,322.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $775.98 / $775.98 / $4,443.75
| Professional | | $775.98 | $775.98 | $4,443.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.17 / $1,782.57 / $3,371.95
| Professional | | $229.17 | $1,782.57 | $3,371.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.00 / $1,523.00 / $6,920.00
| Facility | | $548.00 | $1,523.00 | $6,920.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,090.41 / $1,712.82 / $4,163.30
| Professional | | $1,090.41 | $1,712.82 | $4,163.30 |