- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,618.00 / $3,627.00 / $8,433.00
| Facility | | $2,618.00 | $3,627.00 | $8,433.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $622.01 / $750.34 / $3,256.00
| Professional | | $622.01 | $750.34 | $3,256.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.08 / $6,029.00 / $34,324.12
| Facility | | $1,480.08 | $6,029.00 | $34,324.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.66 / $1,134.18 / $4,016.73
| Professional | | $539.66 | $1,134.18 | $4,016.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,265.34 / $27,707.71 / $35,837.41
| Facility | | $23,265.34 | $27,707.71 | $35,837.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,700.00 / $14,868.13 / $20,251.00
| Facility | | $3,700.00 | $14,868.13 | $20,251.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,176.89 / $1,358.49 / $2,155.42
| Professional | | $1,176.89 | $1,358.49 | $2,155.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.91 / $1,320.86 / $7,315.92
| Facility | | $622.91 | $1,320.86 | $7,315.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.96 / $729.81 / $1,152.38
| Professional | | $392.96 | $729.81 | $1,152.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $792.99 / $1,585.98 / $2,577.21
| Professional | | $792.99 | $1,585.98 | $2,577.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,009.15 / $26,009.15 / $26,009.15
| Facility | | $26,009.15 | $26,009.15 | $26,009.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,540.00 / $7,292.00 / $17,462.00
| Facility | | $2,540.00 | $7,292.00 | $17,462.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $819.58 / $1,299.34 / $4,016.73
| Professional | | $819.58 | $1,299.34 | $4,016.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,540.00 / $7,157.00 / $14,101.00
| Facility | | $2,540.00 | $7,157.00 | $14,101.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $732.90 / $929.06 / $2,136.79
| Professional | | $732.90 | $929.06 | $2,136.79 |