- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,839.00 / $8,247.00
| Facility | | $1,013.00 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $842.01 / $924.38 / $1,351.01
| Professional | | $842.01 | $924.38 | $1,351.01 |
- 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
- $886.79 / $1,293.71 / $1,703.13
| Professional | | $886.79 | $1,293.71 | $1,703.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $869.78 / $1,275.61 / $2,004.11
| Professional | | $869.78 | $1,275.61 | $2,004.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,257.28 / $1,700.56 / $1,700.56
| Professional | | $1,257.28 | $1,700.56 | $1,700.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,247.00
| Facility | | $832.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $842.01 / $1,024.86 / $4,993.89
| Professional | | $842.01 | $1,024.86 | $4,993.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $1,034.30 / $2,510.19
| Professional | | $9.00 | $1,034.30 | $2,510.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $869.78 / $1,261.47 / $2,004.11
| Professional | | $869.78 | $1,261.47 | $2,004.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.61 / $977.61 / $1,025.97
| Facility | | $977.61 | $977.61 | $1,025.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $931.18 / $998.72 / $1,039.65
| Professional | | $931.18 | $998.72 | $1,039.65 |
- 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
- $955.17 / $1,261.48 / $1,982.86
| Professional | | $955.17 | $1,261.48 | $1,982.86 |