- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.12 / $2,747.00 / $8,017.00
| Facility | | $262.12 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.91 / $218.56 / $375.45
| Professional | | $153.91 | $218.56 | $375.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.13 / $266.83 / $266.83
| Professional | | $257.13 | $266.83 | $266.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.88 / $249.95 / $412.21
| Professional | | $171.88 | $249.95 | $412.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.01 / $403.73 / $418.32
| Professional | | $314.01 | $403.73 | $418.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,547.36 / $5,733.58 / $11,918.14
| Facility | | $2,547.36 | $5,733.58 | $11,918.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.80 / $2,875.03 / $8,017.00
| Facility | | $384.80 | $2,875.03 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.66 / $245.69 / $729.69
| Professional | | $155.66 | $245.69 | $729.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.00 / $248.01 / $401.38
| Professional | | $170.00 | $248.01 | $401.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.91 / $301.91 / $301.91
| Facility | | $301.91 | $301.91 | $301.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.94 / $254.32 / $442.80
| Professional | | $176.94 | $254.32 | $442.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.76 / $173.59 / $254.84
| Facility | | $166.76 | $173.59 | $254.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.18 / $206.41 / $273.95
| Professional | | $168.18 | $206.41 | $273.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.67 / $267.94 / $448.55
| Professional | | $187.67 | $267.94 | $448.55 |