- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,038.00 / $5,308.00 / $16,713.00
| Facility | | $1,038.00 | $5,308.00 | $16,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.62 / $1,698.53 / $3,829.68
| Professional | | $142.62 | $1,698.53 | $3,829.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,143.00 / $5,944.00 / $13,707.00
| Facility | | $2,143.00 | $5,944.00 | $13,707.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.43 / $2,896.75 / $5,539.86
| Professional | | $192.43 | $2,896.75 | $5,539.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.00 / $100.00 / $10,317.12
| Facility | | $64.00 | $100.00 | $10,317.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.54 / $562.88 / $3,560.84
| Professional | | $139.54 | $562.88 | $3,560.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.97 / $1,656.70 / $4,023.11
| Professional | | $154.97 | $1,656.70 | $4,023.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.33 / $167.39 / $2,613.28
| Professional | | $127.33 | $167.39 | $2,613.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.78 / $1,197.76 / $2,939.94
| Professional | | $144.78 | $1,197.76 | $2,939.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,967.63 / $2,967.63
| Facility | | $55.00 | $2,967.63 | $2,967.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,069.23 / $11,575.52 / $13,731.90
| Professional | | $6,069.23 | $11,575.52 | $13,731.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.26 / $393.66 / $3,006.69
| Facility | | $159.26 | $393.66 | $3,006.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.19 / $585.41 / $4,099.01
| Professional | | $157.19 | $585.41 | $4,099.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.32 / $484.32 / $4,982.77
| Professional | | $484.32 | $484.32 | $4,982.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.33 / $168.61 / $2,421.84
| Professional | | $127.33 | $168.61 | $2,421.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $13,784.00 / $32,191.00
| Facility | | $7,212.00 | $13,784.00 | $32,191.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,255.49 / $2,134.35 / $4,972.41
| Professional | | $1,255.49 | $2,134.35 | $4,972.41 |