- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,691.53 / $8,317.64
| Facility | | $537.03 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $89.13 / $229.09
| Professional | | $60.26 | $89.13 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $123.03 / $134.90
| Professional | | $102.33 | $123.03 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $95.50 / $158.49
| Professional | | $64.57 | $95.50 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $147.91 / $162.18
| Professional | | $114.82 | $147.91 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $114.82 / $169.82
| Professional | | $79.43 | $114.82 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $891.25
| Facility | | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $100.00 / $109.65
| Professional | | $91.20 | $100.00 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,290.87 / $7,762.47
| Facility | | $537.03 | $2,290.87 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $95.50 / $229.09
| Professional | | $61.66 | $95.50 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Professional | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $75.86 / $97.72
| Facility | | $60.26 | $75.86 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $75.86 / $100.00
| Professional | | $27.54 | $75.86 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $616.60 / $3,890.45
| Facility | | $223.87 | $616.60 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $89.13 / $151.36
| Professional | | $58.88 | $89.13 | $151.36 |