- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.10 / $1,294.00 / $3,377.08
| Facility | | $239.10 | $1,294.00 | $3,377.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.60 / $206.40 / $500.03
| Professional | | $129.60 | $206.40 | $500.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.40 / $2,376.00 / $8,498.00
| Facility | | $405.40 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.30 / $341.94 / $1,202.00
| Professional | | $173.30 | $341.94 | $1,202.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.14 / $257.58 / $454.53
| Facility | | $198.14 | $257.58 | $454.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.43 / $380.39 / $591.88
| Professional | | $252.43 | $380.39 | $591.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.97 / $316.69 / $648.96
| Professional | | $186.97 | $316.69 | $648.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.87 / $361.30 / $6,679.00
| Facility | | $169.87 | $361.30 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.02 / $316.23 / $436.52
| Professional | | $250.02 | $316.23 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.03 / $432.25 / $669.60
| Professional | | $206.03 | $432.25 | $669.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.97 / $1,136.27 / $2,022.88
| Facility | | $741.97 | $1,136.27 | $2,022.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.99 / $177.37 / $320.76
| Professional | | $139.99 | $177.37 | $320.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.60 / $3,372.00 / $12,000.00
| Facility | | $845.60 | $3,372.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.87 / $412.39 / $1,617.12
| Professional | | $234.87 | $412.39 | $1,617.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.70 / $309.68 / $640.14
| Professional | | $187.70 | $309.68 | $640.14 |