- 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
- $974.54 / $1,107.71 / $1,397.41
| Professional | | $974.54 | $1,107.71 | $1,397.41 |
- 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
- $1,098.32 / $1,139.77 / $1,139.77
| Professional | | $1,098.32 | $1,139.77 | $1,139.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,056.16 / $1,419.72 / $2,234.62
| Professional | | $1,056.16 | $1,419.72 | $2,234.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,276.82 / $1,689.02 / $1,694.06
| Professional | | $1,276.82 | $1,689.02 | $1,694.06 |
- 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
- $974.54 / $1,171.51 / $3,479.38
| Professional | | $974.54 | $1,171.51 | $3,479.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $1,413.90 / $2,720.00
| Professional | | $7.00 | $1,413.90 | $2,720.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,060.11 / $1,432.76 / $2,324.38
| Professional | | $1,060.11 | $1,432.76 | $2,324.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.35 / $1,068.35 / $1,133.23
| Facility | | $1,068.35 | $1,068.35 | $1,133.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,035.39 / $1,074.20 / $1,133.23
| Professional | | $1,035.39 | $1,074.20 | $1,133.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,094.73 / $1,430.41 / $2,379.05
| Professional | | $1,094.73 | $1,430.41 | $2,379.05 |