- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.35 / $1,473.20 / $3,363.00
| Facility | | $260.35 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.03 / $165.77 / $355.79
| Professional | | $55.03 | $165.77 | $355.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.44 / $2,376.00 / $8,498.00
| Facility | | $133.44 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.96 / $351.30 / $1,601.68
| Professional | | $62.96 | $351.30 | $1,601.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.09 / $84.94 / $168.56
| Facility | | $66.09 | $84.94 | $168.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.70 / $224.77 / $474.63
| Professional | | $62.70 | $224.77 | $474.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.01 / $211.59 / $600.47
| Professional | | $74.01 | $211.59 | $600.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.14 / $300.00 / $6,679.00
| Facility | | $67.14 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.65 / $303.37 / $424.30
| Professional | | $248.65 | $303.37 | $424.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.04 / $222.12 / $625.29
| Professional | | $77.04 | $222.12 | $625.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $796.88 / $1,009.03 / $1,859.98
| Facility | | $796.88 | $1,009.03 | $1,859.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.72 / $345.00 / $403.05
| Professional | | $73.72 | $345.00 | $403.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.65 / $3,372.00 / $12,000.00
| Facility | | $390.65 | $3,372.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.57 / $499.03 / $1,601.68
| Professional | | $280.57 | $499.03 | $1,601.68 |
- 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
- $243.97 / $388.22 / $777.35
| Professional | | $243.97 | $388.22 | $777.35 |