- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.17 / $2,747.00 / $8,017.00
| Facility | | $789.17 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $684.35 / $789.18 / $894.55
| Professional | | $684.35 | $789.18 | $894.55 |
- 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
- $762.23 / $896.74 / $1,388.52
| Professional | | $762.23 | $896.74 | $1,388.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $841.46 / $1,125.83 / $1,822.53
| Professional | | $841.46 | $1,125.83 | $1,822.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,017.00 / $1,349.07 / $1,349.07
| Professional | | $1,017.00 | $1,349.07 | $1,349.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,995.86 / $17,995.86 / $17,995.86
| Facility | | $17,995.86 | $17,995.86 | $17,995.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,120.00 / $8,017.00
| Facility | | $832.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $684.35 / $807.79 / $1,941.38
| Professional | | $684.35 | $807.79 | $1,941.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.00 / $1,986.30
| Professional | | $5.00 | $5.00 | $1,986.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $846.98 / $1,104.97 / $1,930.24
| Professional | | $846.98 | $1,104.97 | $1,930.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.69 / $847.69 / $865.26
| Facility | | $847.69 | $847.69 | $865.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $821.61 / $852.11 / $890.73
| Professional | | $821.61 | $852.11 | $890.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $7,000.00 / $11,238.00
| Facility | | $3,340.00 | $7,000.00 | $11,238.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $822.89 / $1,080.91 / $1,668.97
| Professional | | $822.89 | $1,080.91 | $1,668.97 |