- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.66 / $1,294.00 / $3,363.00
| Facility | | $258.66 | $1,294.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.97 / $203.25 / $432.11
| Professional | | $134.97 | $203.25 | $432.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.25 / $1,878.00 / $7,161.00
| Facility | | $441.25 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.98 / $351.99 / $1,310.24
| Professional | | $175.98 | $351.99 | $1,310.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.04 / $279.55 / $493.30
| Facility | | $215.04 | $279.55 | $493.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.77 / $429.22 / $599.99
| Professional | | $275.77 | $429.22 | $599.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.91 / $332.79 / $681.47
| Professional | | $202.91 | $332.79 | $681.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.88 / $294.08 / $6,679.00
| Facility | | $180.88 | $294.08 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.11 / $320.56 / $442.50
| Professional | | $254.11 | $320.56 | $442.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.23 / $463.60 / $701.85
| Professional | | $223.23 | $463.60 | $701.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.77 / $184.83 / $546.30
| Professional | | $175.77 | $184.83 | $546.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,078.00 / $11,500.00
| Facility | | $1,106.00 | $2,078.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.79 / $421.80 / $1,651.36
| Professional | | $244.79 | $421.80 | $1,651.36 |
- 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
- $204.39 / $314.17 / $649.41
| Professional | | $204.39 | $314.17 | $649.41 |