- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,758.00 / $2,747.00 / $8,608.06
| Facility | | $1,758.00 | $2,747.00 | $8,608.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.34 / $1,568.70 / $15,055.18
| Professional | | $417.34 | $1,568.70 | $15,055.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.10 / $5,071.00 / $22,645.14
| Facility | | $941.10 | $5,071.00 | $22,645.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $574.90 / $13,534.87 / $34,802.96
| Professional | | $574.90 | $13,534.87 | $34,802.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.60 / $804.18 / $1,577.43
| Facility | | $618.60 | $804.18 | $1,577.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $842.01 / $4,021.89 / $24,946.66
| Professional | | $842.01 | $4,021.89 | $24,946.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.50 / $1,127.94 / $6,679.00
| Facility | | $535.50 | $1,127.94 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,220.00 / $12,109.24 / $21,497.24
| Professional | | $10,220.00 | $12,109.24 | $21,497.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $671.74 / $9,929.11 / $21,992.98
| Professional | | $671.74 | $9,929.11 | $21,992.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,501.85 / $8,959.68 / $10,373.75
| Facility | | $4,501.85 | $8,959.68 | $10,373.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $787.64 / $873.65 / $1,668.07
| Professional | | $787.64 | $873.65 | $1,668.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $6,238.00 / $17,462.00
| Facility | | $55.00 | $6,238.00 | $17,462.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13,040.72 / $21,492.13 / $58,351.86
| Professional | | $13,040.72 | $21,492.13 | $58,351.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,485.00 / $6,474.00 / $13,737.00
| Facility | | $2,485.00 | $6,474.00 | $13,737.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,686.69 / $16,129.24 / $28,369.55
| Professional | | $11,686.69 | $16,129.24 | $28,369.55 |