- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.35 / $2,410.00 / $3,571.16
| Facility | | $522.35 | $2,410.00 | $3,571.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.08 / $350.42 / $790.09
| Professional | | $101.08 | $350.42 | $790.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.75 / $2,376.00 / $8,498.00
| Facility | | $298.75 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.77 / $627.66 / $5,686.46
| Professional | | $161.77 | $627.66 | $5,686.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.34 / $189.33 / $375.72
| Facility | | $147.34 | $189.33 | $375.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.24 / $386.23 / $815.58
| Professional | | $125.24 | $386.23 | $815.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.32 / $388.71 / $1,149.86
| Professional | | $162.32 | $388.71 | $1,149.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.03 / $300.00 / $6,679.00
| Facility | | $129.03 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.89 / $524.48 / $729.12
| Professional | | $429.89 | $524.48 | $729.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.47 / $427.92 / $1,080.68
| Professional | | $173.47 | $427.92 | $1,080.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $744.00 / $3,103.34 / $3,660.72
| Facility | | $744.00 | $3,103.34 | $3,660.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.64 / $261.52 / $382.92
| Professional | | $199.64 | $261.52 | $382.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.71 / $3,372.00 / $16,394.00
| Facility | | $629.71 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.62 / $1,157.04 / $5,686.46
| Professional | | $493.62 | $1,157.04 | $5,686.46 |
- 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
- $383.53 / $827.81 / $1,618.85
| Professional | | $383.53 | $827.81 | $1,618.85 |