- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.90 / $9,705.15 / $22,114.36
| Facility | | $823.90 | $9,705.15 | $22,114.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.38 / $909.40 / $6,059.39
| Professional | | $297.38 | $909.40 | $6,059.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.84 / $158.84 / $299.42
| Professional | | $158.84 | $158.84 | $299.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,765.00 / $20,811.78 / $38,216.76
| Facility | | $6,765.00 | $20,811.78 | $38,216.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.45 / $598.85 / $4,259.21
| Professional | | $292.45 | $598.85 | $4,259.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,036.70 / $9,036.70 / $11,612.34
| Facility | | $9,036.70 | $9,036.70 | $11,612.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.92 / $848.09 / $7,689.16
| Professional | | $407.92 | $848.09 | $7,689.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.49 / $3,961.91 / $7,379.11
| Facility | | $353.49 | $3,961.91 | $7,379.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $800.20 / $8,025.24 / $10,544.82
| Facility | 50 | $800.20 | $8,025.24 | $10,544.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,471.15 / $7,995.34 / $10,080.77
| Professional | | $5,471.15 | $7,995.34 | $10,080.77 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $8,206.73 / $8,206.73 / $15,121.16
| Professional | 50 | $8,206.73 | $8,206.73 | $15,121.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,801.04 / $3,591.83 / $5,385.29
| Professional | | $2,801.04 | $3,591.83 | $5,385.29 |
- 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
- $3,096.97 / $4,893.97 / $9,936.46
| Professional | | $3,096.97 | $4,893.97 | $9,936.46 |