- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.12 / $1,845.24 / $3,469.00
| Facility | | $319.12 | $1,845.24 | $3,469.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.25 / $267.27 / $820.60
| Professional | | $174.25 | $267.27 | $820.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.61 / $1,878.00 / $7,161.00
| Facility | | $537.61 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.18 / $469.41 / $1,616.08
| Professional | | $234.18 | $469.41 | $1,616.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.39 / $333.31 / $588.16
| Facility | | $256.39 | $333.31 | $588.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.93 / $340.45 / $511.72
| Professional | | $217.93 | $340.45 | $511.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.94 / $418.85 / $883.44
| Professional | | $248.94 | $418.85 | $883.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.04 / $467.50 / $6,679.00
| Facility | | $224.04 | $467.50 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.55 / $425.39 / $587.21
| Professional | | $340.55 | $425.39 | $587.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.66 / $578.41 / $916.36
| Professional | | $275.66 | $578.41 | $916.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.80 / $2,793.01 / $3,441.50
| Facility | | $1,301.80 | $2,793.01 | $3,441.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,078.00 / $16,394.00
| Facility | | $1,106.00 | $2,078.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.11 / $588.55 / $2,231.60
| Professional | | $342.11 | $588.55 | $2,231.60 |
- 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
- $300.29 / $447.92 / $913.56
| Professional | | $300.29 | $447.92 | $913.56 |