- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $2,747.00 / $8,017.00
| Facility | | $1,020.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $898.92 / $1,042.02 / $1,286.88
| Professional | | $898.92 | $1,042.02 | $1,286.88 |
- 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
- $1,013.57 / $1,051.82 / $1,051.82
| Professional | | $1,013.57 | $1,051.82 | $1,051.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $964.84 / $1,311.37 / $1,999.05
| Professional | | $964.84 | $1,311.37 | $1,999.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,180.76 / $1,562.07 / $1,569.09
| Professional | | $1,180.76 | $1,562.07 | $1,569.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,669.45 / $13,669.45 / $13,669.45
| Facility | | $13,669.45 | $13,669.45 | $13,669.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,120.00 / $8,017.00
| Facility | | $954.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $898.92 / $1,078.16 / $2,612.75
| Professional | | $898.92 | $1,078.16 | $2,612.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $1,267.40 / $2,519.19
| Professional | | $7.00 | $1,267.40 | $2,519.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $978.46 / $1,322.39 / $2,113.02
| Professional | | $978.46 | $1,322.39 | $2,113.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $984.74 / $984.74 / $1,038.91
| Facility | | $984.74 | $984.74 | $1,038.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $955.15 / $989.29 / $1,038.91
| Professional | | $955.15 | $989.29 | $1,038.91 |
- 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
- $948.44 / $1,236.13 / $2,036.75
| Professional | | $948.44 | $1,236.13 | $2,036.75 |