- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.10 / $2,747.00 / $8,247.00
| Facility | | $183.10 | $2,747.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.63 / $166.33 / $238.87
| Professional | | $91.63 | $166.33 | $238.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.71 / $196.13 / $321.55
| Professional | | $166.71 | $196.13 | $321.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.22 / $236.22 / $236.22
| Facility | | $236.22 | $236.22 | $236.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.07 / $257.24 / $983.81
| Professional | | $234.07 | $257.24 | $983.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.01 / $276.70 / $328.63
| Professional | | $153.01 | $276.70 | $328.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,761.00 / $8,427.00
| Facility | | $832.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.63 / $180.62 / $1,426.00
| Professional | | $91.63 | $180.62 | $1,426.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.22 / $236.22 / $236.22
| Facility | | $236.22 | $236.22 | $236.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.07 / $257.24 / $983.81
| Professional | | $234.07 | $257.24 | $983.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.00 / $122.22 / $200.95
| Facility | | $111.00 | $122.22 | $200.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.00 / $194.40 / $208.41
| Professional | | $111.00 | $194.40 | $208.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $1,305.00 / $3,742.00
| Facility | | $471.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.30 / $238.01 / $352.03
| Professional | | $178.30 | $238.01 | $352.03 |