- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.67 / $2,618.00 / $3,693.00
| Facility | | $243.67 | $2,618.00 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.65 / $288.13 / $679.14
| Professional | | $182.65 | $288.13 | $679.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $1,878.00 / $7,161.00
| Facility | | $540.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.99 / $486.42 / $1,651.44
| Professional | | $241.99 | $486.42 | $1,651.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.37 / $347.58 / $613.35
| Facility | | $267.37 | $347.58 | $613.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.82 / $533.66 / $824.72
| Professional | | $362.82 | $533.66 | $824.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.84 / $431.50 / $908.37
| Professional | | $255.84 | $431.50 | $908.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $341.26 / $6,679.00
| Facility | | $214.32 | $341.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.96 / $440.63 / $608.24
| Professional | | $349.96 | $440.63 | $608.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.99 / $589.60 / $934.07
| Professional | | $280.99 | $589.60 | $934.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.18 / $781.18 / $3,441.50
| Facility | | $496.18 | $781.18 | $3,441.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.75 / $496.75 / $650.21
| Professional | | $496.75 | $496.75 | $650.21 |
- 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
- $341.06 / $602.72 / $2,278.96
| Professional | | $341.06 | $602.72 | $2,278.96 |
- 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
- $269.64 / $440.53 / $817.54
| Professional | | $269.64 | $440.53 | $817.54 |