- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.21 / $4,249.22 / $7,462.23
| Facility | | $508.21 | $4,249.22 | $7,462.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.21 / $508.21 / $2,361.19
| Professional | | $508.21 | $508.21 | $2,361.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,809.14 / $2,800.01 / $11,630.66
| Facility | | $1,809.14 | $2,800.01 | $11,630.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.10 / $2,267.29 / $9,194.42
| Professional | | $602.10 | $2,267.29 | $9,194.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,891.82 / $5,565.30 / $9,729.54
| Facility | | $3,891.82 | $5,565.30 | $9,729.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,301.65 / $2,301.65 / $2,424.07
| Professional | | $2,301.65 | $2,301.65 | $2,424.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.55 / $1,710.97 / $4,773.72
| Facility | | $432.55 | $1,710.97 | $4,773.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $939.41 / $2,202.66 / $10,926.20
| Professional | | $939.41 | $2,202.66 | $10,926.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,533.28 / $3,533.28 / $4,156.80
| Professional | | $3,533.28 | $3,533.28 | $4,156.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,448.56 / $2,448.56 / $7,582.95
| Professional | | $2,448.56 | $2,448.56 | $7,582.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.00 / $1,500.00 / $1,500.00
| Facility | | $572.00 | $1,500.00 | $1,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,260.49 / $11,630.66 / $11,630.66
| Facility | | $4,260.49 | $11,630.66 | $11,630.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.26 / $1,469.14 / $12,242.80
| Professional | | $361.26 | $1,469.14 | $12,242.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.26 / $1,469.14 / $4,667.13
| Professional | | $361.26 | $1,469.14 | $4,667.13 |