- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.04 / $6,403.52 / $7,124.22
| Facility | | $0.04 | $6,403.52 | $7,124.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,571.42 / $3,599.98 / $3,927.25
| Professional | | $2,571.42 | $3,599.98 | $3,927.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,732.13 / $6,502.03 / $8,541.07
| Facility | | $2,732.13 | $6,502.03 | $8,541.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,402.59 / $2,337.65 / $9,270.25
| Professional | | $1,402.59 | $2,337.65 | $9,270.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,337.65 / $3,342.84 / $5,844.13
| Facility | | $2,337.65 | $3,342.84 | $5,844.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,197.39 / $2,197.39 / $2,197.39
| Professional | | $2,197.39 | $2,197.39 | $2,197.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,503.97 / $1,689.01 / $5,318.15
| Facility | | $1,503.97 | $1,689.01 | $5,318.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,402.52 / $2,466.29 / $10,430.87
| Professional | | $1,402.52 | $2,466.29 | $10,430.87 |
- 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
- $3,373.18 / $3,373.18 / $3,968.45
| Professional | | $3,373.18 | $3,373.18 | $3,968.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,337.65 / $2,337.65 / $7,239.47
| Professional | | $2,337.65 | $2,337.65 | $7,239.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,067.51 / $11,103.84 / $11,103.84
| Facility | | $4,067.51 | $11,103.84 | $11,103.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,402.59 / $1,402.59 / $11,688.25
| Professional | | $1,402.59 | $1,402.59 | $11,688.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,402.59 / $1,402.59 / $4,175.18
| Professional | | $1,402.59 | $1,402.59 | $4,175.18 |