- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.41 / $2,547.00 / $3,625.00
| Facility | | $240.41 | $2,547.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.31 / $157.15 / $658.26
| Professional | | $64.31 | $157.15 | $658.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.56 / $1,251.81 / $3,472.00
| Facility | | $184.56 | $1,251.81 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.93 / $577.41 / $1,306.05
| Professional | | $87.93 | $577.41 | $1,306.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.25 / $122.53 / $240.34
| Facility | | $94.25 | $122.53 | $240.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.79 / $379.16 / $1,054.80
| Professional | | $110.79 | $379.16 | $1,054.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $171.86 / $6,679.00
| Facility | | $83.43 | $171.86 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.39 / $499.67 / $698.44
| Professional | | $394.39 | $499.67 | $698.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.58 / $365.92 / $1,034.47
| Professional | | $101.58 | $365.92 | $1,034.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.17 / $103.69 / $465.79
| Facility | | $99.17 | $103.69 | $465.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.22 / $124.22 / $128.69
| Professional | | $124.22 | $124.22 | $128.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,600.00 / $7,161.00
| Facility | | $55.00 | $1,600.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.83 / $857.29 / $2,523.76
| Professional | | $538.83 | $857.29 | $2,523.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.49 / $666.81 / $1,092.58
| Professional | | $430.49 | $666.81 | $1,092.58 |