- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.58 / $1,537.60 / $3,870.20
| Facility | | $211.58 | $1,537.60 | $3,870.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.88 / $172.29 / $457.04
| Professional | | $111.88 | $172.29 | $457.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.00 / $1,251.81 / $7,161.00
| Facility | | $369.00 | $1,251.81 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.03 / $301.39 / $1,095.83
| Professional | | $153.03 | $301.39 | $1,095.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.95 / $235.24 / $415.10
| Facility | | $180.95 | $235.24 | $415.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.54 / $326.24 / $499.26
| Professional | | $228.54 | $326.24 | $499.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.87 / $278.77 / $572.87
| Professional | | $164.87 | $278.77 | $572.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.86 / $247.47 / $6,679.00
| Facility | | $154.86 | $247.47 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.86 / $279.45 / $385.76
| Professional | | $220.86 | $279.45 | $385.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.19 / $391.71 / $608.37
| Professional | | $187.19 | $391.71 | $608.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.10 / $952.56 / $2,421.37
| Facility | | $158.10 | $952.56 | $2,421.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.18 / $216.14 / $626.67
| Professional | | $144.18 | $216.14 | $626.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.73 / $2,078.00 / $11,500.00
| Facility | | $773.73 | $2,078.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.81 / $364.14 / $1,429.84
| Professional | | $205.81 | $364.14 | $1,429.84 |
- 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
- $168.39 / $272.95 / $542.54
| Professional | | $168.39 | $272.95 | $542.54 |