- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.54 / $1,819.00 / $5,750.00
| Facility | | $156.54 | $1,819.00 | $5,750.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.08 / $483.60 / $1,248.56
| Professional | | $78.08 | $483.60 | $1,248.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.66 / $956.22 / $1,491.10
| Professional | | $478.66 | $956.22 | $1,491.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.70 / $545.04 / $1,308.08
| Professional | | $96.70 | $545.04 | $1,308.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $857.41 / $884.00 / $2,254.40
| Professional | | $857.41 | $884.00 | $2,254.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $565.29 / $1,004.27 / $2,192.31
| Facility | | $565.29 | $1,004.27 | $2,192.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $1,741.00 / $6,432.00
| Facility | | $480.00 | $1,741.00 | $6,432.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.73 / $483.60 / $1,732.81
| Professional | | $79.73 | $483.60 | $1,732.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.45 / $742.46 / $1,101.40
| Professional | | $111.45 | $742.46 | $1,101.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.48 / $563.13 / $1,308.08
| Professional | | $98.48 | $563.13 | $1,308.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.76 / $98.53 / $833.80
| Facility | | $87.76 | $98.53 | $833.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.76 / $566.61 / $629.95
| Professional | | $87.76 | $566.61 | $629.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $637.16 / $890.75 / $1,423.80
| Professional | | $637.16 | $890.75 | $1,423.80 |