- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.73 / $1,978.00 / $7,629.00
| Facility | | $188.73 | $1,978.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.42 / $178.12 / $337.46
| Professional | | $117.42 | $178.12 | $337.46 |
- 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
- $201.64 / $209.25 / $326.98
| Professional | | $201.64 | $209.25 | $326.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.41 / $196.38 / $336.82
| Professional | | $124.41 | $196.38 | $336.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.07 / $309.95 / $318.98
| Professional | | $241.07 | $309.95 | $318.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.47 / $201.70 / $236.97
| Professional | | $197.47 | $201.70 | $236.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,326.00 / $8,017.00
| Facility | | $540.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.67 / $188.73 / $403.88
| Professional | | $121.67 | $188.73 | $403.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.46 / $188.30 / $282.66
| Professional | | $128.46 | $188.30 | $282.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.81 / $230.81 / $230.81
| Facility | | $230.81 | $230.81 | $230.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.46 / $199.74 / $363.31
| Professional | | $128.46 | $199.74 | $363.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.59 / $138.32 / $199.62
| Facility | | $132.59 | $138.32 | $199.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.52 / $192.68 / $213.56
| Professional | | $132.52 | $192.68 | $213.56 |
- 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
- $175.18 / $221.91 / $394.79
| Professional | | $175.18 | $221.91 | $394.79 |