- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.00 / $2,547.00 / $3,693.00
| Facility | | $699.00 | $2,547.00 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.32 / $264.63 / $530.65
| Professional | | $161.32 | $264.63 | $530.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $519.08 / $1,251.81 / $7,161.00
| Facility | | $519.08 | $1,251.81 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.93 / $472.08 / $1,544.72
| Professional | | $226.93 | $472.08 | $1,544.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.17 / $325.22 / $573.89
| Facility | | $250.17 | $325.22 | $573.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.02 / $449.03 / $778.82
| Professional | | $285.02 | $449.03 | $778.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.77 / $425.70 / $884.73
| Professional | | $238.77 | $425.70 | $884.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.03 / $456.16 / $6,679.00
| Facility | | $216.03 | $456.16 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.52 / $435.94 / $601.76
| Professional | | $345.52 | $435.94 | $601.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.55 / $555.82 / $920.30
| Professional | | $262.55 | $555.82 | $920.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $889.96 / $1,153.21 / $2,833.26
| Facility | | $889.96 | $1,153.21 | $2,833.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.97 / $245.21 / $752.28
| Professional | | $244.97 | $245.21 | $752.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.60 / $2,078.00 / $16,394.00
| Facility | | $1,068.60 | $2,078.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.12 / $594.74 / $2,246.16
| Professional | | $291.12 | $594.74 | $2,246.16 |
- 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
- $226.93 / $435.77 / $932.69
| Professional | | $226.93 | $435.77 | $932.69 |