- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,449.01 / $10,005.99 / $23,876.00
| Facility | | $2,449.01 | $10,005.99 | $23,876.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,080.82 / $7,933.82 / $10,005.99
| Professional | | $3,080.82 | $7,933.82 | $10,005.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,591.00 / $5,063.00 / $13,773.00
| Facility | | $1,591.00 | $5,063.00 | $13,773.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.28 / $5,128.13 / $13,156.70
| Professional | | $205.28 | $5,128.13 | $13,156.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49,922.00 / $52,419.00 / $56,064.00
| Facility | | $49,922.00 | $52,419.00 | $56,064.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,821.49 / $2,821.49 / $2,981.98
| Professional | | $2,821.49 | $2,821.49 | $2,981.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,909.00 / $5,602.16 / $13,379.56
| Facility | | $1,909.00 | $5,602.16 | $13,379.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,783.68 / $5,817.62 / $9,178.92
| Professional | | $4,783.68 | $5,817.62 | $9,178.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,811.16 / $8,581.67 / $11,525.74
| Professional | | $4,811.16 | $8,581.67 | $11,525.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,603.68 / $1,603.68 / $1,603.68
| Facility | | $1,603.68 | $1,603.68 | $1,603.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $6,204.00 / $13,773.00
| Facility | | $2,324.00 | $6,204.00 | $13,773.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.69 / $4,989.29 / $20,170.37
| Professional | | $171.69 | $4,989.29 | $20,170.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $5,097.00 / $10,764.00
| Facility | | $2,324.00 | $5,097.00 | $10,764.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.69 / $4,777.89 / $8,827.76
| Professional | | $171.69 | $4,777.89 | $8,827.76 |