- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,839.00 / $8,427.00
| Facility | | $1,013.00 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $997.30 / $1,164.83 / $1,682.90
| Professional | | $997.30 | $1,164.83 | $1,682.90 |
- 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
- $990.37 / $1,578.65 / $2,128.60
| Professional | | $990.37 | $1,578.65 | $2,128.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,084.17 / $1,468.18 / $2,286.16
| Professional | | $1,084.17 | $1,468.18 | $2,286.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,304.84 / $1,726.00 / $1,731.34
| Professional | | $1,304.84 | $1,726.00 | $1,731.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,427.00
| Facility | | $1,013.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $997.30 / $1,209.21 / $2,843.00
| Professional | | $997.30 | $1,209.21 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,545.50 / $2,782.60
| Professional | | $6.00 | $1,545.50 | $2,782.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,112.18 / $1,486.12 / $2,546.69
| Professional | | $1,112.18 | $1,486.12 | $2,546.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,092.21 / $1,092.21 / $1,382.89
| Facility | | $1,092.21 | $1,092.21 | $1,382.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,058.50 / $1,098.20 / $1,382.89
| Professional | | $1,058.50 | $1,098.20 | $1,382.89 |
- 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
- $1,127.19 / $1,387.71 / $2,301.17
| Professional | | $1,127.19 | $1,387.71 | $2,301.17 |