- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.21 / $1,809.66 / $3,693.00
| Facility | | $157.21 | $1,809.66 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.38 / $185.60 / $532.70
| Professional | | $119.38 | $185.60 | $532.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.70 / $2,376.00 / $8,498.00
| Facility | | $385.70 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.88 / $312.91 / $1,157.52
| Professional | | $157.88 | $312.91 | $1,157.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.94 / $246.92 / $435.72
| Facility | | $189.94 | $246.92 | $435.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.89 / $340.90 / $497.78
| Professional | | $239.89 | $340.90 | $497.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.23 / $299.83 / $595.59
| Professional | | $179.23 | $299.83 | $595.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.94 / $259.74 / $6,679.00
| Facility | | $162.94 | $259.74 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.61 / $289.89 / $400.17
| Professional | | $229.61 | $289.89 | $400.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.02 / $410.31 / $633.51
| Professional | | $197.02 | $410.31 | $633.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.49 / $826.43 / $1,853.98
| Facility | | $152.49 | $826.43 | $1,853.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.55 / $166.56 / $245.28
| Professional | | $157.55 | $166.56 | $245.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,095.96 / $3,372.00 / $11,500.00
| Facility | | $1,095.96 | $3,372.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.81 / $379.63 / $1,491.52
| Professional | | $220.81 | $379.63 | $1,491.52 |
- 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
- $180.72 / $283.39 / $560.86
| Professional | | $180.72 | $283.39 | $560.86 |