- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $501.19 / $1,023.29
| Facility | | $81.28 | $501.19 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $630.96 / $1,000.00
| Professional | | $407.38 | $630.96 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.02 / $125.89 / $1,479.11
| Professional | | $0.02 | $125.89 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $53,703.18
| Facility | | $141.25 | $141.25 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $1,318.26
| Professional | | $812.83 | $812.83 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $144.54 / $346.74
| Facility | | $89.13 | $144.54 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,513.56 / $2,454.71
| Professional | | $1,288.25 | $1,513.56 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $812.83 / $977.24
| Professional | | $489.78 | $812.83 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,288.25 / $1,445.44
| Professional | | $1,023.29 | $1,288.25 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $4,677.35 / $6,025.60
| Facility | | $3,235.94 | $4,677.35 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $870.96 / $1,698.24
| Professional | | $109.65 | $870.96 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $97.72 / $97.72
| Facility | | $74.13 | $97.72 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $741.31 / $851.14
| Professional | | $97.72 | $741.31 | $851.14 |