- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,534.32 / $4,771.00 / $9,539.00
| Facility | | $1,534.32 | $4,771.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,290.07 / $1,534.32 / $2,034.31
| Professional | | $1,290.07 | $1,534.32 | $2,034.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,807.00 / $17,284.09 / $24,194.30
| Facility | | $7,807.00 | $17,284.09 | $24,194.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,250.04 / $1,601.87 / $2,264.40
| Professional | | $1,250.04 | $1,601.87 | $2,264.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,508.14 / $1,511.10 / $2,940.87
| Professional | | $1,508.14 | $1,511.10 | $2,940.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $610.00 / $1,547.29
| Facility | | $490.00 | $610.00 | $1,547.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,165.42 / $1,653.75 / $2,945.90
| Professional | | $1,165.42 | $1,653.75 | $2,945.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,256.04 / $1,551.57 / $2,216.54
| Professional | | $1,256.04 | $1,551.57 | $2,216.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,397.13 / $1,747.53 / $2,593.00
| Facility | | $1,397.13 | $1,747.53 | $2,593.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,636.00 / $1,880.03 / $3,130.42
| Professional | | $1,636.00 | $1,880.03 | $3,130.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,317.11 / $1,637.86 / $3,004.31
| Facility | | $1,317.11 | $1,637.86 | $3,004.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,317.11 / $1,637.86 / $3,004.31
| Professional | | $1,317.11 | $1,637.86 | $3,004.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.00 / $2,397.00 / $5,202.00
| Facility | | $327.00 | $2,397.00 | $5,202.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,055.18 / $1,594.44 / $2,676.69
| Professional | | $1,055.18 | $1,594.44 | $2,676.69 |