- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.93 / $1,294.00 / $3,103.52
| Facility | | $232.93 | $1,294.00 | $3,103.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.23 / $238.70 / $733.76
| Professional | | $62.23 | $238.70 | $733.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.31 / $613.65 / $2,733.00
| Facility | | $179.31 | $613.65 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.38 / $708.71 / $1,801.39
| Professional | | $89.38 | $708.71 | $1,801.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.56 / $119.03 / $233.48
| Facility | | $91.56 | $119.03 | $233.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.75 / $182.75 / $917.68
| Professional | | $182.75 | $182.75 | $917.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.63 / $558.69 / $1,420.51
| Professional | | $143.63 | $558.69 | $1,420.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $300.00 / $6,679.00
| Facility | | $83.43 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.08 / $545.98 / $976.18
| Professional | | $432.08 | $545.98 | $976.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.18 / $327.72 / $1,005.26
| Professional | | $101.18 | $327.72 | $1,005.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.26 / $2,767.27 / $4,027.05
| Facility | | $195.26 | $2,767.27 | $4,027.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $597.50 / $1,066.58 / $2,658.80
| Professional | | $597.50 | $1,066.58 | $2,658.80 |
- 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
- $590.59 / $838.32 / $1,464.96
| Professional | | $590.59 | $838.32 | $1,464.96 |