- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $3,801.89 / $5,623.41
| Facility | | $2,691.53 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,466.84 / $5,370.32 / $15,135.61
| Professional | | $4,466.84 | $5,370.32 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,754.23 / $43,651.58
| Facility | | $56.23 | $2,754.23 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,466.84 / $6,918.31 / $34,673.69
| Professional | | $4,466.84 | $6,918.31 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,549.93 / $12,589.25
| Professional | | $6,456.54 | $9,549.93 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $1,380.38
| Facility | | $50.12 | $676.08 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $6,309.57 / $13,182.57
| Professional | | $588.84 | $6,309.57 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $5,888.44 / $9,332.54
| Facility | | $302.00 | $5,888.44 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,677.35 / $6,606.93 / $9,772.37
| Professional | | $4,677.35 | $6,606.93 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $2,454.71 / $4,677.35
| Facility | | $295.12 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,128.31 / $12,302.69
| Professional | | $4,570.88 | $8,128.31 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,754.23 / $43,651.58
| Facility | | $56.23 | $2,754.23 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,918.31 / $34,673.69
| Professional | | $4,570.88 | $6,918.31 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,754.23 / $4,677.35
| Facility | | $794.33 | $2,754.23 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,918.31 / $13,489.63
| Professional | | $4,570.88 | $6,918.31 | $13,489.63 |