- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.05 / $2,663.12 / $3,625.00
| Facility | | $208.05 | $2,663.12 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.86 / $245.79 / $474.51
| Professional | | $145.86 | $245.79 | $474.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.41 / $1,251.81 / $7,161.00
| Facility | | $444.41 | $1,251.81 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.21 / $408.99 / $1,323.04
| Professional | | $200.21 | $408.99 | $1,323.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.77 / $279.20 / $492.68
| Facility | | $214.77 | $279.20 | $492.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.33 / $439.56 / $646.54
| Professional | | $275.33 | $439.56 | $646.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.54 / $367.52 / $759.58
| Professional | | $208.54 | $367.52 | $759.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.51 / $293.72 / $6,679.00
| Facility | | $181.51 | $293.72 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.04 / $376.53 / $519.76
| Professional | | $298.04 | $376.53 | $519.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.46 / $475.18 / $768.27
| Professional | | $224.46 | $475.18 | $768.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.20 / $558.39 / $12,287.83
| Facility | | $279.20 | $558.39 | $12,287.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.33 / $423.39 / $434.14
| Professional | | $329.33 | $423.39 | $434.14 |
- 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
- $290.12 / $512.38 / $1,936.16
| Professional | | $290.12 | $512.38 | $1,936.16 |
- 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
- $247.83 / $376.31 / $732.00
| Professional | | $247.83 | $376.31 | $732.00 |