- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.11 / $2,747.00 / $7,625.00
| Facility | | $318.11 | $2,747.00 | $7,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.77 / $318.11 / $453.64
| Professional | | $311.77 | $318.11 | $453.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.35 / $5,097.00 / $13,366.09
| Facility | | $818.35 | $5,097.00 | $13,366.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.92 / $541.05 / $5,386.21
| Professional | | $317.92 | $541.05 | $5,386.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,507.96 / $9,076.00 / $11,769.07
| Facility | | $7,507.96 | $9,076.00 | $11,769.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,354.27 / $17,752.75 / $48,139.00
| Facility | | $5,354.27 | $17,752.75 | $48,139.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.92 / $677.45 / $1,074.85
| Professional | | $559.92 | $677.45 | $1,074.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.43 / $300.00 / $6,679.00
| Facility | | $98.43 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.88 / $210.25 / $483.99
| Professional | | $75.88 | $210.25 | $483.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.59 / $733.18 / $1,191.42
| Professional | | $366.59 | $733.18 | $1,191.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,204.71 / $5,904.00 / $15,421.00
| Facility | | $2,204.71 | $5,904.00 | $15,421.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.50 / $639.64 / $5,386.21
| Professional | | $424.50 | $639.64 | $5,386.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $5,904.00 / $15,053.00
| Facility | | $2,386.00 | $5,904.00 | $15,053.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.02 / $590.83 / $1,402.50
| Professional | | $420.02 | $590.83 | $1,402.50 |