- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.00 / $2,572.00 / $7,542.00
| Facility | | $669.00 | $2,572.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.32 / $233.36 / $2,121.25
| Professional | | $55.32 | $233.36 | $2,121.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.64 / $47.81 / $2,713.25
| Professional | | $40.64 | $47.81 | $2,713.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.27 / $48.27 / $6,034.89
| Facility | | $48.27 | $48.27 | $6,034.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,250.93 / $4,250.93 / $4,250.93
| Professional | | $4,250.93 | $4,250.93 | $4,250.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $255.86 / $277.20 / $277.20
| Facility | | $255.86 | $277.20 | $277.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.20 / $22,830.08 / $51,110.33
| Professional | | $417.20 | $22,830.08 | $51,110.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.96 / $232.26 / $7,185.18
| Facility | | $53.96 | $232.26 | $7,185.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.34 / $109.34 / $5,338.53
| Professional | | $68.34 | $109.34 | $5,338.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.96 / $232.26 / $7,057.75
| Facility | | $53.96 | $232.26 | $7,057.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.66 / $3,066.56 / $4,871.67
| Professional | | $53.66 | $3,066.56 | $4,871.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $952.00 / $2,405.00
| Facility | | $161.00 | $952.00 | $2,405.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,540.94 / $2,054.58 / $3,188.07
| Professional | | $1,540.94 | $2,054.58 | $3,188.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,531.26 / $5,527.06 / $7,737.88
| Professional | | $2,531.26 | $5,527.06 | $7,737.88 |