- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $948.67 / $3,839.00 / $8,427.00
| Facility | | $948.67 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $885.23 / $999.27 / $1,247.64
| Professional | | $885.23 | $999.27 | $1,247.64 |
- 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
- $1,058.00 / $1,097.92 / $1,097.92
| Professional | | $1,058.00 | $1,097.92 | $1,097.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $998.11 / $1,348.87 / $2,135.67
| Professional | | $998.11 | $1,348.87 | $2,135.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,249.20 / $1,660.53 / $1,660.53
| Professional | | $1,249.20 | $1,660.53 | $1,660.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $948.67 / $4,761.00 / $8,427.00
| Facility | | $948.67 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $885.23 / $1,088.97 / $2,777.40
| Professional | | $885.23 | $1,088.97 | $2,777.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,150.40 / $2,678.10
| Professional | | $6.00 | $1,150.40 | $2,678.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,009.33 / $1,369.85 / $2,246.94
| Professional | | $1,009.33 | $1,369.85 | $2,246.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,044.89 / $1,044.89 / $1,149.68
| Facility | | $1,044.89 | $1,044.89 | $1,149.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,009.55 / $1,053.57 / $1,149.68
| Professional | | $1,009.55 | $1,053.57 | $1,149.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,222.00 / $3,475.00 / $6,000.00
| Facility | | $2,222.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $990.41 / $1,338.50 / $2,138.03
| Professional | | $990.41 | $1,338.50 | $2,138.03 |