- 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
- $876.90 / $973.87 / $1,407.09
| Professional | | $876.90 | $973.87 | $1,407.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.76 / $1,087.30 / $1,087.30
| Professional | | $1,047.76 | $1,087.30 | $1,087.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $908.48 / $1,301.60 / $2,189.98
| Professional | | $908.48 | $1,301.60 | $2,189.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,310.08 / $1,771.57 / $1,771.57
| Professional | | $1,310.08 | $1,771.57 | $1,771.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,247.00
| Facility | | $1,013.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $888.85 / $1,067.83 / $2,843.00
| Professional | | $888.85 | $1,067.83 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $869.10 / $2,617.80
| Professional | | $9.00 | $869.10 | $2,617.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $880.82 / $1,309.39 / $2,199.46
| Professional | | $880.82 | $1,309.39 | $2,199.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.11 / $1,018.60 / $1,018.60
| Facility | | $720.11 | $1,018.60 | $1,018.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $720.11 / $1,018.60 / $1,083.58
| Professional | | $720.11 | $1,018.60 | $1,083.58 |
- 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
- $883.93 / $1,302.44 / $2,057.17
| Professional | | $883.93 | $1,302.44 | $2,057.17 |