- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.73 / $2,008.89 / $6,461.00
| Facility | | $362.73 | $2,008.89 | $6,461.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.14 / $1,102.03 / $2,405.80
| Professional | | $308.14 | $1,102.03 | $2,405.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,060.00 / $8,139.00 / $11,136.00
| Facility | | $5,060.00 | $8,139.00 | $11,136.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.39 / $1,924.60 / $7,864.90
| Professional | | $541.39 | $1,924.60 | $7,864.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,163.17 / $4,865.00 / $7,847.07
| Facility | | $4,163.17 | $4,865.00 | $7,847.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.16 / $1,329.21 / $6,043.96
| Professional | | $537.16 | $1,329.21 | $6,043.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.91 / $625.41 / $2,879.70
| Facility | | $312.91 | $625.41 | $2,879.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.77 / $3,087.46 / $11,598.00
| Facility | | $333.77 | $3,087.46 | $11,598.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,812.51 / $4,953.39 / $7,956.11
| Professional | | $1,812.51 | $4,953.39 | $7,956.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.00 / $1,388.60 / $3,730.32
| Professional | | $85.00 | $1,388.60 | $3,730.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.91 / $625.41 / $2,879.70
| Facility | | $312.91 | $625.41 | $2,879.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $677.60 / $1,588.44 / $5,014.81
| Professional | | $677.60 | $1,588.44 | $5,014.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,722.25 / $2,722.25 / $2,722.25
| Facility | | $2,722.25 | $2,722.25 | $2,722.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.32 / $5,316.91 / $11,287.52
| Professional | | $549.32 | $5,316.91 | $11,287.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,716.73 / $6,055.24 / $10,762.52
| Professional | | $1,716.73 | $6,055.24 | $10,762.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,073.00 / $9,837.00 / $12,062.00
| Facility | | $6,073.00 | $9,837.00 | $12,062.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,581.08 / $4,710.32 / $6,917.79
| Professional | | $1,581.08 | $4,710.32 | $6,917.79 |