- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.83 / $9,674.00 / $21,960.90
| Facility | | $941.83 | $9,674.00 | $21,960.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $774.13 / $882.41 / $968.18
| Professional | | $774.13 | $882.41 | $968.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,143.00 / $5,769.00 / $11,233.00
| Facility | | $2,143.00 | $5,769.00 | $11,233.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.30 / $563.79 / $1,068.08
| Professional | | $399.30 | $563.79 | $1,068.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.80 / $100.00 / $5,305.65
| Facility | | $65.80 | $100.00 | $5,305.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.07 / $389.93 / $839.48
| Professional | | $264.07 | $389.93 | $839.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.20 / $1,044.51 / $1,989.03
| Professional | | $313.20 | $1,044.51 | $1,989.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.32 / $313.16 / $313.16
| Professional | | $248.32 | $313.16 | $313.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.54 / $404.26 / $718.00
| Professional | | $364.54 | $404.26 | $718.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $8,043.97 / $10,450.00
| Facility | | $55.00 | $8,043.97 | $10,450.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,626.56 / $5,971.20 / $6,740.33
| Professional | | $5,626.56 | $5,971.20 | $6,740.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.54 / $473.90 / $1,133.38
| Facility | | $364.54 | $473.90 | $1,133.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.20 / $1,044.51 / $2,260.90
| Professional | | $309.20 | $1,044.51 | $2,260.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.32 / $383.56 / $527.40
| Professional | | $248.32 | $383.56 | $527.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.00 / $1,533.00 / $6,920.00
| Facility | | $548.00 | $1,533.00 | $6,920.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.37 / $419.22 / $1,190.26
| Professional | | $281.37 | $419.22 | $1,190.26 |