- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.25 / $1,823.00 / $3,693.00
| Facility | | $318.25 | $1,823.00 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.04 / $160.91 / $398.06
| Professional | | $85.04 | $160.91 | $398.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.37 / $736.00 / $3,445.00
| Facility | | $263.37 | $736.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.89 / $236.84 / $773.60
| Professional | | $118.89 | $236.84 | $773.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.57 / $165.84 / $292.64
| Facility | | $127.57 | $165.84 | $292.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.22 / $254.63 / $378.38
| Professional | | $166.22 | $254.63 | $378.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.37 / $211.62 / $432.93
| Professional | | $120.37 | $211.62 | $432.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.11 / $214.32 / $6,679.00
| Facility | | $109.11 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.57 / $219.91 / $304.18
| Professional | | $173.57 | $219.91 | $304.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.47 / $278.33 / $459.65
| Professional | | $131.47 | $278.33 | $459.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.66 / $502.92 / $2,135.40
| Facility | | $148.66 | $502.92 | $2,135.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.58 / $223.77 / $284.82
| Professional | | $111.58 | $223.77 | $284.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.58 / $1,818.00 / $11,500.00
| Facility | | $546.58 | $1,818.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.94 / $287.12 / $1,121.92
| Professional | | $160.94 | $287.12 | $1,121.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.10 / $214.50 / $443.39
| Professional | | $130.10 | $214.50 | $443.39 |