- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.42 / $7,597.10 / $16,052.55
| Facility | | $815.42 | $7,597.10 | $16,052.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $663.12 / $3,633.00 / $9,394.86
| Professional | | $663.12 | $3,633.00 | $9,394.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,266.00 / $8,669.00 / $11,373.00
| Facility | | $6,266.00 | $8,669.00 | $11,373.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.23 / $2,186.44 / $8,449.64
| Professional | | $621.23 | $2,186.44 | $8,449.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $695.91 / $945.84 / $19,633.00
| Professional | | $695.91 | $945.84 | $19,633.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $732.26 / $1,849.78 / $11,457.71
| Professional | | $732.26 | $1,849.78 | $11,457.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,894.07 / $7,082.28 / $8,852.85
| Professional | | $5,894.07 | $7,082.28 | $8,852.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $788.28 / $5,894.07 / $11,469.76
| Facility | | $788.28 | $5,894.07 | $11,469.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,205.75 / $8,432.00 / $11,940.00
| Professional | | $2,205.75 | $8,432.00 | $11,940.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $690.08 / $922.45 / $13,902.00
| Facility | | $690.08 | $922.45 | $13,902.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,759.30 / $9,056.11 / $16,954.00
| Professional | | $6,759.30 | $9,056.11 | $16,954.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,301.00 / $20,974.00 / $40,876.00
| Facility | | $12,301.00 | $20,974.00 | $40,876.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,472.21 / $10,112.82 / $15,300.03
| Professional | | $6,472.21 | $10,112.82 | $15,300.03 |