- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.54 / $2,547.00 / $4,161.35
| Facility | | $599.54 | $2,547.00 | $4,161.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.61 / $137.75 / $382.10
| Professional | | $76.61 | $137.75 | $382.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.46 / $1,866.13 / $4,755.00
| Facility | | $203.46 | $1,866.13 | $4,755.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.42 / $224.27 / $3,306.22
| Professional | | $101.42 | $224.27 | $3,306.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.91 / $138.97 / $245.29
| Facility | | $106.91 | $138.97 | $245.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.41 / $226.47 / $379.54
| Professional | | $136.41 | $226.47 | $379.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.96 / $191.91 / $415.76
| Professional | | $103.96 | $191.91 | $415.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.79 / $300.00 / $6,679.00
| Facility | | $93.79 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.93 / $221.03 / $305.11
| Professional | | $175.93 | $221.03 | $305.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.69 / $243.14 / $468.51
| Professional | | $114.69 | $243.14 | $468.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,852.05 / $3,217.80 / $3,885.41
| Facility | | $2,852.05 | $3,217.80 | $3,885.41 |
- 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
- $171.92 / $280.88 / $3,737.30
| Professional | | $171.92 | $280.88 | $3,737.30 |
- 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
- $168.55 / $242.70 / $545.00
| Professional | | $168.55 | $242.70 | $545.00 |