- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.78 / $2,067.21 / $3,693.00
| Facility | | $236.78 | $2,067.21 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.78 / $195.93 / $611.00
| Professional | | $114.78 | $195.93 | $611.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.21 / $1,052.09 / $3,445.00
| Facility | | $356.21 | $1,052.09 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.53 / $341.05 / $1,130.00
| Professional | | $164.53 | $341.05 | $1,130.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.84 / $229.89 / $405.67
| Facility | | $176.84 | $229.89 | $405.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.31 / $235.14 / $371.53
| Professional | | $150.31 | $235.14 | $371.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.57 / $305.89 / $627.54
| Professional | | $172.57 | $305.89 | $627.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.13 / $322.45 / $6,679.00
| Facility | | $154.13 | $322.45 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.08 / $321.58 / $443.91
| Professional | | $256.08 | $321.58 | $443.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.24 / $400.62 / $636.36
| Professional | | $189.24 | $400.62 | $636.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.29 / $1,300.20 / $3,191.93
| Facility | | $562.29 | $1,300.20 | $3,191.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $16,394.00
| Facility | | $627.00 | $1,818.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.27 / $430.82 / $1,669.92
| Professional | | $254.27 | $430.82 | $1,669.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.93 / $814.18 / $1,184.92
| Facility | | $261.93 | $814.18 | $1,184.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $3,445.00
| Facility | | $627.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.44 / $328.34 / $662.72
| Professional | | $219.44 | $328.34 | $662.72 |