- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.00 / $2,747.00 / $8,017.00
| Facility | | $216.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.32 / $203.38 / $295.27
| Professional | | $131.32 | $203.38 | $295.27 |
- 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
- $231.00 / $239.71 / $239.71
| Professional | | $231.00 | $239.71 | $239.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.76 / $218.44 / $374.24
| Professional | | $139.76 | $218.44 | $374.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.33 / $355.29 / $365.76
| Professional | | $276.33 | $355.29 | $365.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.48 / $213.48 / $225.82
| Professional | | $213.48 | $213.48 | $225.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.66 / $214.88 / $462.24
| Professional | | $136.66 | $214.88 | $462.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.46 / $214.00 / $323.88
| Professional | | $144.46 | $214.00 | $323.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.70 / $259.70 / $259.70
| Facility | | $259.70 | $259.70 | $259.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.46 / $228.25 / $416.29
| Professional | | $144.46 | $228.25 | $416.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.05 / $167.94 / $235.57
| Facility | | $149.05 | $167.94 | $235.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.02 / $224.58 / $244.71
| Professional | | $149.02 | $224.58 | $244.71 |
- 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
- $197.05 / $253.94 / $428.29
| Professional | | $197.05 | $253.94 | $428.29 |