- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.65 / $1,642.00 / $3,363.00
| Facility | | $246.65 | $1,642.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.66 / $227.46 / $636.41
| Professional | | $64.66 | $227.46 | $636.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.01 / $1,251.81 / $3,472.00
| Facility | | $195.01 | $1,251.81 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.00 / $656.80 / $1,669.44
| Professional | | $92.00 | $656.80 | $1,669.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.25 / $122.53 / $240.34
| Facility | | $94.25 | $122.53 | $240.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.07 / $188.12 / $876.44
| Professional | | $94.07 | $188.12 | $876.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.21 / $444.22 / $1,354.55
| Professional | | $147.21 | $444.22 | $1,354.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.95 / $171.86 / $8,090.00
| Facility | | $82.95 | $171.86 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.10 / $522.00 / $933.30
| Professional | | $413.10 | $522.00 | $933.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.12 / $369.05 / $961.71
| Professional | | $104.12 | $369.05 | $961.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.18 / $1,005.77 / $3,583.40
| Facility | | $201.18 | $1,005.77 | $3,583.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.09 / $257.37 / $257.37
| Professional | | $71.09 | $257.37 | $257.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,878.00 / $7,161.00
| Facility | | $55.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $547.33 / $975.71 / $2,545.28
| Professional | | $547.33 | $975.71 | $2,545.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.09 / $728.45 / $1,357.65
| Professional | | $527.09 | $728.45 | $1,357.65 |