- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.11 / $1,023.00 / $3,363.00
| Facility | | $212.11 | $1,023.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.93 / $174.77 / $471.30
| Professional | | $110.93 | $174.77 | $471.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.30 / $1,251.81 / $7,161.00
| Facility | | $364.30 | $1,251.81 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.97 / $293.81 / $1,076.24
| Professional | | $149.97 | $293.81 | $1,076.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.63 / $230.92 / $407.48
| Facility | | $177.63 | $230.92 | $407.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.35 / $318.83 / $468.14
| Professional | | $224.35 | $318.83 | $468.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.00 / $279.01 / $563.66
| Professional | | $167.00 | $279.01 | $563.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.90 / $242.91 / $6,679.00
| Facility | | $151.90 | $242.91 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.38 / $272.63 / $376.34
| Professional | | $215.38 | $272.63 | $376.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.09 / $383.13 / $592.71
| Professional | | $183.09 | $383.13 | $592.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.91 / $704.19 / $4,129.56
| Facility | | $140.91 | $704.19 | $4,129.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.01 / $232.21 / $313.77
| Professional | | $153.01 | $232.21 | $313.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,019.52 / $2,078.00 / $11,500.00
| Facility | | $1,019.52 | $2,078.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.33 / $355.64 / $1,395.92
| Professional | | $207.33 | $355.64 | $1,395.92 |
- 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
- $168.47 / $272.92 / $530.74
| Professional | | $168.47 | $272.92 | $530.74 |