- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.43 / $2,083.00 / $3,625.00
| Facility | | $261.43 | $2,083.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.87 / $317.07 / $902.12
| Professional | | $219.87 | $317.07 | $902.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.73 / $897.68 / $2,713.00
| Facility | | $312.73 | $897.68 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.00 / $533.97 / $2,026.48
| Professional | | $264.00 | $533.97 | $2,026.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.29 / $430.68 / $759.98
| Facility | | $331.29 | $430.68 | $759.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.35 / $594.60 / $846.51
| Professional | | $418.35 | $594.60 | $846.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.67 / $513.53 / $1,050.35
| Professional | | $321.67 | $513.53 | $1,050.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $422.86 / $6,679.00
| Facility | | $214.32 | $422.86 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.94 / $486.30 / $671.28
| Professional | | $385.94 | $486.30 | $671.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.65 / $706.99 / $949.36
| Professional | | $343.65 | $706.99 | $949.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,225.28 / $1,225.28 / $1,225.28
| Facility | | $1,225.28 | $1,225.28 | $1,225.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.92 / $540.92 / $540.92
| Professional | | $540.92 | $540.92 | $540.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,418.92 / $3,445.00
| Facility | | $55.00 | $1,418.92 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.48 / $648.30 / $2,515.60
| Professional | | $373.48 | $648.30 | $2,515.60 |
- 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
- $354.38 / $487.09 / $939.82
| Professional | | $354.38 | $487.09 | $939.82 |