- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,924.00 / $2,747.00 / $5,048.00
| Facility | | $1,924.00 | $2,747.00 | $5,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $637.66 / $778.55 / $1,680.11
| Professional | | $637.66 | $778.55 | $1,680.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,483.36 / $5,268.00 / $16,223.75
| Facility | | $1,483.36 | $5,268.00 | $16,223.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $636.99 / $1,249.36 / $18,994.34
| Professional | | $636.99 | $1,249.36 | $18,994.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $820.45 / $1,220.29 / $1,647.95
| Professional | | $820.45 | $1,220.29 | $1,647.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $826.73 / $1,275.06 / $2,351.13
| Professional | | $826.73 | $1,275.06 | $2,351.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $633.01 / $1,352.64 / $6,679.00
| Facility | | $633.01 | $1,352.64 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.12 / $726.38 / $1,171.07
| Professional | | $390.12 | $726.38 | $1,171.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $788.07 / $1,571.73 / $2,367.75
| Professional | | $788.07 | $1,571.73 | $2,367.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,301.83 / $8,301.83 / $12,392.58
| Facility | | $8,301.83 | $8,301.83 | $12,392.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.94 / $144.94 / $1,127.64
| Professional | | $144.94 | $144.94 | $1,127.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $6,104.00 / $26,542.00
| Facility | | $2,155.00 | $6,104.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $727.32 / $1,352.64 / $18,994.34
| Professional | | $727.32 | $1,352.64 | $18,994.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $682.80 / $945.37 / $2,315.90
| Professional | | $682.80 | $945.37 | $2,315.90 |