- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.04 / $8,876.00 / $41,930.53
| Facility | | $656.04 | $8,876.00 | $41,930.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.03 / $1,318.20 / $4,197.53
| Professional | | $429.03 | $1,318.20 | $4,197.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.66 / $570.63 / $610.53
| Professional | | $558.66 | $570.63 | $610.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,731.78 / $20,855.96 / $38,216.76
| Facility | | $8,731.78 | $20,855.96 | $38,216.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.99 / $849.60 / $4,259.21
| Professional | | $418.99 | $849.60 | $4,259.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,937.76 / $8,937.76 / $11,485.18
| Facility | | $8,937.76 | $8,937.76 | $11,485.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.19 / $1,222.10 / $6,425.97
| Professional | | $582.19 | $1,222.10 | $6,425.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.38 / $3,163.27 / $6,524.85
| Facility | | $509.38 | $3,163.27 | $6,524.85 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,153.08 / $5,501.00 / $9,794.23
| Facility | 50 | $1,153.08 | $5,501.00 | $9,794.23 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $153.74 / $733.47 / $1,305.90
| Facility | 80 | $153.74 | $733.47 | $1,305.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,471.15 / $7,907.79 / $9,863.67
| Professional | | $5,471.15 | $7,907.79 | $9,863.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,274.70 / $2,903.30 / $4,377.07
| Professional | | $2,274.70 | $2,903.30 | $4,377.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $21,721.00 / $33,299.00
| Facility | | $3,340.00 | $21,721.00 | $33,299.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,149.45 / $4,052.94 / $9,103.49
| Professional | | $3,149.45 | $4,052.94 | $9,103.49 |