- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,262.00 / $8,451.00
| Facility | | $1,013.00 | $4,262.00 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.04 / $1,382.38 / $2,206.50
| Professional | | $300.04 | $1,382.38 | $2,206.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,302.00 / $1,589.57 / $1,589.57
| Professional | | $1,302.00 | $1,589.57 | $1,589.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.81 / $1,614.62 / $3,412.46
| Professional | | $369.81 | $1,614.62 | $3,412.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,884.42 / $2,501.84 / $2,582.00
| Professional | | $1,884.42 | $2,501.84 | $2,582.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.00 / $5,342.00 / $9,617.00
| Facility | | $1,054.00 | $5,342.00 | $9,617.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.17 / $1,496.93 / $3,126.85
| Professional | | $317.17 | $1,496.93 | $3,126.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $2,762.90 / $4,775.30
| Professional | | $3.00 | $2,762.90 | $4,775.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.39 / $1,659.73 / $3,499.76
| Professional | | $371.39 | $1,659.73 | $3,499.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $349.35 / $451.90 / $2,632.64
| Facility | | $349.35 | $451.90 | $2,632.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.35 / $1,600.08 / $1,770.56
| Professional | | $349.35 | $1,600.08 | $1,770.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,745.77 / $2,493.65 / $3,654.96
| Professional | | $1,745.77 | $2,493.65 | $3,654.96 |