- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.94 / $2,547.00 / $3,693.00
| Facility | | $107.94 | $2,547.00 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.34 / $119.12 / $258.41
| Professional | | $66.34 | $119.12 | $258.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.71 / $1,866.13 / $4,755.00
| Facility | | $182.71 | $1,866.13 | $4,755.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.95 / $209.15 / $2,700.31
| Professional | | $90.95 | $209.15 | $2,700.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.52 / $125.48 / $237.91
| Facility | | $96.52 | $125.48 | $237.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.63 / $210.00 / $383.01
| Professional | | $129.63 | $210.00 | $383.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.71 / $183.25 / $405.89
| Professional | | $93.71 | $183.25 | $405.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.20 / $300.00 / $6,679.00
| Facility | | $84.20 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.72 / $214.38 / $295.93
| Professional | | $169.72 | $214.38 | $295.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.22 / $223.88 / $451.79
| Professional | | $103.22 | $223.88 | $451.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.58 / $2,751.61 / $3,885.41
| Facility | | $572.58 | $2,751.61 | $3,885.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.75 / $123.75 / $123.75
| Professional | | $123.75 | $123.75 | $123.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,338.00 / $8,498.00
| Facility | | $55.00 | $2,338.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.81 / $258.45 / $2,987.99
| Professional | | $164.81 | $258.45 | $2,987.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.33 / $219.88 / $418.85
| Professional | | $160.33 | $219.88 | $418.85 |