- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.46 / $4,264.00 / $8,240.00
| Facility | | $1,030.46 | $4,264.00 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $915.07 / $992.48 / $1,272.08
| Professional | | $915.07 | $992.48 | $1,272.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,027.55 / $1,066.33 / $1,066.33
| Professional | | $1,027.55 | $1,066.33 | $1,066.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $903.21 / $1,301.75 / $2,177.34
| Professional | | $903.21 | $1,301.75 | $2,177.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,244.78 / $1,666.79 / $1,666.79
| Professional | | $1,244.78 | $1,666.79 | $1,666.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,761.00 / $8,247.00
| Facility | | $1,020.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $910.95 / $1,063.49 / $5,100.00
| Professional | | $910.95 | $1,063.49 | $5,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,222.59 / $2,607.60
| Professional | | $6.00 | $1,222.59 | $2,607.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $991.42 / $1,319.76 / $2,177.34
| Professional | | $991.42 | $1,319.76 | $2,177.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,003.38 / $1,003.38 / $1,003.38
| Facility | | $1,003.38 | $1,003.38 | $1,003.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $964.64 / $1,016.31 / $1,060.34
| Professional | | $964.64 | $1,016.31 | $1,060.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $906.48 / $1,193.54 / $2,022.92
| Professional | | $906.48 | $1,193.54 | $2,022.92 |