- 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
- $951.09 / $1,080.53 / $1,362.68
| Professional | | $951.09 | $1,080.53 | $1,362.68 |
- 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
- $945.46 / $1,505.93 / $1,994.37
| Professional | | $945.46 | $1,505.93 | $1,994.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,034.13 / $1,419.96 / $2,184.73
| Professional | | $1,034.13 | $1,419.96 | $2,184.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,246.55 / $1,649.14 / $1,653.71
| Professional | | $1,246.55 | $1,649.14 | $1,653.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,247.00
| Facility | | $1,013.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $951.09 / $1,136.67 / $2,843.00
| Professional | | $951.09 | $1,136.67 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,510.50 / $2,655.50
| Professional | | $6.00 | $1,510.50 | $2,655.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,061.75 / $1,444.25 / $2,476.17
| Professional | | $1,061.75 | $1,444.25 | $2,476.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.90 / $1,041.90 / $1,345.15
| Facility | | $1,041.90 | $1,041.90 | $1,345.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,009.84 / $1,047.51 / $1,345.15
| Professional | | $1,009.84 | $1,047.51 | $1,345.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,228.00
| Facility | | $625.00 | $2,391.00 | $6,228.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,066.80 / $1,323.52 / $2,164.31
| Professional | | $1,066.80 | $1,323.52 | $2,164.31 |