- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.94 / $1,486.00 / $3,398.55
| Facility | | $344.94 | $1,486.00 | $3,398.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.16 / $342.98 / $921.39
| Professional | | $216.16 | $342.98 | $921.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.38 / $947.00 / $3,445.00
| Facility | | $568.38 | $947.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.39 / $560.29 / $1,757.92
| Professional | | $263.39 | $560.29 | $1,757.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.50 / $368.55 / $650.35
| Facility | | $283.50 | $368.55 | $650.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.96 / $629.79 / $1,014.14
| Professional | | $407.96 | $629.79 | $1,014.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.24 / $574.67 / $1,200.70
| Professional | | $304.24 | $574.67 | $1,200.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.23 / $516.94 / $6,679.00
| Facility | | $245.23 | $516.94 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $428.74 / $541.82 / $747.93
| Professional | | $428.74 | $541.82 | $747.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.19 / $631.27 / $1,050.61
| Professional | | $298.19 | $631.27 | $1,050.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,103.34 / $3,103.34 / $3,103.34
| Facility | | $3,103.34 | $3,103.34 | $3,103.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.23 / $312.98 / $587.94
| Professional | | $305.23 | $312.98 | $587.94 |
- 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
- $379.01 / $726.83 / $2,783.84
| Professional | | $379.01 | $726.83 | $2,783.84 |
- 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
- $358.16 / $570.14 / $1,166.82
| Professional | | $358.16 | $570.14 | $1,166.82 |