- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $4,761.00 / $8,933.00
| Facility | | $921.00 | $4,761.00 | $8,933.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $705.15 / $823.06 / $1,284.18
| Professional | | $705.15 | $823.06 | $1,284.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,850.00 / $16,455.00 / $36,032.05
| Facility | | $8,850.00 | $16,455.00 | $36,032.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $742.35 / $1,148.15 / $1,531.74
| Professional | | $742.35 | $1,148.15 | $1,531.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $832.82 / $1,109.28 / $1,940.11
| Professional | | $832.82 | $1,109.28 | $1,940.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $994.49 / $1,321.96 / $1,321.96
| Professional | | $994.49 | $1,321.96 | $1,321.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,552.63 / $44,552.63 / $44,552.63
| Facility | | $44,552.63 | $44,552.63 | $44,552.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.00 / $5,342.00 / $10,247.00
| Facility | | $1,054.00 | $5,342.00 | $10,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $705.15 / $992.44 / $2,660.00
| Professional | | $705.15 | $992.44 | $2,660.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $1,146.59 / $2,133.40
| Professional | | $6.00 | $1,146.59 | $2,133.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $853.29 / $1,109.28 / $1,965.35
| Professional | | $853.29 | $1,109.28 | $1,965.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.03 / $831.03 / $1,032.27
| Facility | | $831.03 | $831.03 | $1,032.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $803.54 / $837.61 / $1,032.27
| Professional | | $803.54 | $837.61 | $1,032.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,899.00 / $4,564.00 / $8,261.00
| Facility | | $1,899.00 | $4,564.00 | $8,261.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $808.73 / $1,071.60 / $1,793.75
| Professional | | $808.73 | $1,071.60 | $1,793.75 |