- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.86 / $1,758.00 / $3,469.00
| Facility | | $274.86 | $1,758.00 | $3,469.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.47 / $282.99 / $806.83
| Professional | | $155.47 | $282.99 | $806.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.21 / $947.00 / $3,445.00
| Facility | | $485.21 | $947.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.69 / $471.29 / $1,492.72
| Professional | | $225.69 | $471.29 | $1,492.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.36 / $315.07 / $555.97
| Facility | | $242.36 | $315.07 | $555.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.88 / $527.29 / $838.45
| Professional | | $328.88 | $527.29 | $838.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.13 / $489.52 / $983.01
| Professional | | $257.13 | $489.52 | $983.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.97 / $441.92 / $6,679.00
| Facility | | $208.97 | $441.92 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.48 / $469.31 / $647.84
| Professional | | $370.48 | $469.31 | $647.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.54 / $537.50 / $903.08
| Professional | | $253.54 | $537.50 | $903.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.41 / $513.86 / $3,103.34
| Facility | | $265.41 | $513.86 | $3,103.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.42 / $528.83 / $640.52
| Professional | | $294.42 | $528.83 | $640.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $16,394.00
| Facility | | $627.00 | $1,818.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.43 / $608.16 / $2,399.36
| Professional | | $302.43 | $608.16 | $2,399.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.98 / $453.06 / $916.51
| Professional | | $277.98 | $453.06 | $916.51 |