- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.52 / $2,706.37 / $9,818.81
| Facility | | $222.52 | $2,706.37 | $9,818.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.33 / $2,427.48 / $4,618.42
| Professional | | $219.33 | $2,427.48 | $4,618.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,538.00 / $9,720.00 / $15,579.70
| Facility | | $6,538.00 | $9,720.00 | $15,579.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.77 / $2,015.32 / $13,380.85
| Professional | | $310.77 | $2,015.32 | $13,380.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,636.09 / $8,923.37 / $14,393.09
| Facility | | $7,636.09 | $8,923.37 | $14,393.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.93 / $994.17 / $9,647.93
| Professional | | $396.93 | $994.17 | $9,647.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.52 / $480.46 / $4,618.42
| Facility | | $222.52 | $480.46 | $4,618.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.74 / $4,635.00 / $15,126.00
| Facility | | $240.74 | $4,635.00 | $15,126.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,074.16 / $7,338.51 / $18,635.77
| Professional | | $3,074.16 | $7,338.51 | $18,635.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.00 / $2,357.05 / $6,809.89
| Professional | | $70.00 | $2,357.05 | $6,809.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.52 / $480.46 / $4,618.42
| Facility | | $222.52 | $480.46 | $4,618.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.57 / $2,566.00 / $9,007.58
| Professional | | $538.57 | $2,566.00 | $9,007.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,694.22 / $1,694.22 / $1,694.22
| Facility | | $1,694.22 | $1,694.22 | $1,694.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.98 / $1,796.64 / $20,446.96
| Professional | | $333.98 | $1,796.64 | $20,446.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $779.40 / $1,346.05 / $15,877.30
| Professional | | $779.40 | $1,346.05 | $15,877.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,301.00 / $11,608.00 / $13,980.00
| Facility | | $7,301.00 | $11,608.00 | $13,980.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,525.12 / $10,245.41 / $16,163.77
| Professional | | $3,525.12 | $10,245.41 | $16,163.77 |