- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.24 / $2,618.00 / $3,625.00
| Facility | | $282.24 | $2,618.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.18 / $282.24 / $455.31
| Professional | | $170.18 | $282.24 | $455.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.52 / $947.00 / $3,445.00
| Facility | | $515.52 | $947.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.28 / $538.38 / $1,594.80
| Professional | | $239.28 | $538.38 | $1,594.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.83 / $333.89 / $592.65
| Facility | | $256.83 | $333.89 | $592.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.09 / $585.29 / $999.56
| Professional | | $360.09 | $585.29 | $999.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.07 / $515.70 / $1,132.72
| Professional | | $274.07 | $515.70 | $1,132.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.55 / $468.32 / $6,679.00
| Facility | | $222.55 | $468.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.99 / $534.03 / $737.18
| Professional | | $421.99 | $534.03 | $737.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.56 / $568.27 / $1,030.54
| Professional | | $271.56 | $568.27 | $1,030.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.59 / $499.59 / $499.59
| Facility | | $499.59 | $499.59 | $499.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $674.39 / $674.39 / $674.39
| Professional | | $674.39 | $674.39 | $674.39 |
- 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
- $346.74 / $696.50 / $2,732.88
| Professional | | $346.74 | $696.50 | $2,732.88 |
- 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
- $289.44 / $525.55 / $1,044.74
| Professional | | $289.44 | $525.55 | $1,044.74 |