- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.69 / $2,696.00 / $7,629.00
| Facility | | $311.69 | $2,696.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.31 / $281.14 / $412.71
| Professional | | $193.31 | $281.14 | $412.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.00 / $5,951.00 / $8,887.00
| Facility | | $2,450.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.83 / $456.05 / $620.66
| Professional | | $312.83 | $456.05 | $620.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.71 / $349.36 / $601.46
| Professional | | $223.71 | $349.36 | $601.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.01 / $509.84 / $509.84
| Professional | | $382.01 | $509.84 | $509.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,072.74 / $8,665.58 / $12,914.15
| Facility | | $3,072.74 | $8,665.58 | $12,914.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.88 / $313.88 / $313.88
| Professional | | $313.88 | $313.88 | $313.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.00 / $3,077.00 / $8,017.00
| Facility | | $574.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.82 / $311.45 / $880.11
| Professional | | $195.82 | $311.45 | $880.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.45 / $448.43 / $661.96
| Professional | | $231.45 | $448.43 | $661.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.29 / $354.16 / $601.46
| Professional | | $232.29 | $354.16 | $601.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $233.54 / $365.46
| Facility | | $218.78 | $233.54 | $365.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $312.31 / $343.70
| Professional | | $218.78 | $312.31 | $343.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.50 / $383.67 / $684.18
| Professional | | $261.50 | $383.67 | $684.18 |