- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.71 / $2,067.00 / $3,685.00
| Facility | | $116.71 | $2,067.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.35 / $116.71 / $245.18
| Professional | | $50.35 | $116.71 | $245.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.94 / $2,871.43 / $10,821.00
| Facility | | $162.94 | $2,871.43 | $10,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.23 / $224.22 / $1,037.83
| Professional | | $75.23 | $224.22 | $1,037.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.95 / $100.05 / $196.25
| Facility | | $76.95 | $100.05 | $196.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.90 / $191.01 / $351.12
| Professional | | $107.90 | $191.01 | $351.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.12 / $242.97 / $470.90
| Professional | | $120.12 | $242.97 | $470.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.61 / $300.00 / $6,679.00
| Facility | | $78.61 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.57 / $211.74 / $373.75
| Professional | | $167.57 | $211.74 | $373.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.07 / $185.99 / $398.29
| Professional | | $86.07 | $185.99 | $398.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.08 / $1,673.98 / $1,813.34
| Facility | | $580.08 | $1,673.98 | $1,813.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.75 / $226.64 / $294.00
| Professional | | $91.75 | $226.64 | $294.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.95 / $3,649.00 / $12,000.00
| Facility | | $323.95 | $3,649.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.79 / $388.31 / $1,037.83
| Professional | | $158.79 | $388.31 | $1,037.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.26 / $225.72 / $489.93
| Professional | | $134.26 | $225.72 | $489.93 |