- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.46 / $1,426.00 / $7,175.00
| Facility | | $223.46 | $1,426.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.32 / $130.46 / $236.61
| Professional | | $96.32 | $130.46 | $236.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.72 / $159.52 / $159.52
| Professional | | $153.72 | $159.52 | $159.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.27 / $151.18 / $270.39
| Professional | | $107.27 | $151.18 | $270.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.99 / $237.84 / $245.76
| Professional | | $184.99 | $237.84 | $245.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.64 / $434.15 / $859.39
| Facility | | $292.64 | $434.15 | $859.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.76 / $2,463.00 / $8,017.00
| Facility | | $521.76 | $2,463.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.77 / $147.18 / $699.00
| Professional | | $100.77 | $147.18 | $699.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.90 / $151.90 / $159.60
| Professional | | $151.90 | $151.90 | $159.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.70 / $187.70 / $187.70
| Facility | | $187.70 | $187.70 | $187.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.01 / $157.29 / $293.42
| Professional | | $109.01 | $157.29 | $293.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.41 / $108.67 / $153.36
| Facility | | $107.41 | $108.67 | $153.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.41 / $148.18 / $161.88
| Professional | | $107.41 | $148.18 | $161.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.26 / $160.27 / $301.37
| Professional | | $126.26 | $160.27 | $301.37 |