- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.13 / $1,442.00 / $6,012.00
| Facility | | $389.13 | $1,442.00 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.01 / $268.27 / $827.09
| Professional | | $120.01 | $268.27 | $827.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $596.78 / $990.16 / $1,414.70
| Professional | | $596.78 | $990.16 | $1,414.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.41 / $327.41 / $1,006.93
| Professional | | $132.41 | $327.41 | $1,006.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $730.40 / $939.09 / $968.22
| Professional | | $730.40 | $939.09 | $968.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $944.00 / $1,507.60 / $2,476.73
| Facility | | $944.00 | $1,507.60 | $2,476.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.13 / $1,849.62 / $7,175.00
| Facility | | $389.13 | $1,849.62 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.28 / $356.42 / $1,243.83
| Professional | | $131.28 | $356.42 | $1,243.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.12 / $833.24 / $919.70
| Professional | | $126.12 | $833.24 | $919.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.02 / $229.02 / $229.02
| Facility | | $229.02 | $229.02 | $229.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.33 / $394.60 / $1,009.21
| Professional | | $134.33 | $394.60 | $1,009.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.81 / $172.26 / $811.73
| Facility | | $131.81 | $172.26 | $811.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.81 / $612.33 / $677.10
| Professional | | $131.81 | $612.33 | $677.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.00 / $1,305.00 / $4,300.00
| Facility | | $435.00 | $1,305.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.33 / $749.08 / $1,199.42
| Professional | | $539.33 | $749.08 | $1,199.42 |