- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,839.00 / $8,247.00
| Facility | | $1,013.00 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $853.14 / $952.09 / $1,233.24
| Professional | | $853.14 | $952.09 | $1,233.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.12 / $1,332.69 / $1,759.33
| Professional | | $851.12 | $1,332.69 | $1,759.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $865.60 / $1,212.01 / $1,948.91
| Professional | | $865.60 | $1,212.01 | $1,948.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,170.00 / $1,565.96 / $1,565.96
| Professional | | $1,170.00 | $1,565.96 | $1,565.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $853.14 / $1,027.67 / $2,843.00
| Professional | | $853.14 | $1,027.67 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $1,080.59 / $2,437.90
| Professional | | $7.00 | $1,080.59 | $2,437.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $905.34 / $1,225.71 / $1,968.74
| Professional | | $905.34 | $1,225.71 | $1,968.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.69 / $936.69 / $1,077.19
| Facility | | $936.69 | $936.69 | $1,077.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $901.77 / $947.48 / $1,077.19
| Professional | | $901.77 | $947.48 | $1,077.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.00 / $2,391.00 / $6,228.00
| Facility | | $656.00 | $2,391.00 | $6,228.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $815.06 / $1,138.85 / $1,936.25
| Professional | | $815.06 | $1,138.85 | $1,936.25 |