- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.83 / $2,663.12 / $3,693.00
| Facility | | $193.83 | $2,663.12 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.32 / $193.83 / $488.81
| Professional | | $137.32 | $193.83 | $488.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.07 / $1,339.09 / $3,804.00
| Facility | | $248.07 | $1,339.09 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.16 / $349.23 / $1,714.73
| Professional | | $168.16 | $349.23 | $1,714.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.97 / $228.69 / $408.26
| Facility | | $177.97 | $228.69 | $408.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.96 / $338.18 / $485.91
| Professional | | $232.96 | $338.18 | $485.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.43 / $316.55 / $578.37
| Professional | | $186.43 | $316.55 | $578.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.58 / $243.38 / $6,679.00
| Facility | | $152.58 | $243.38 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.39 / $307.93 / $425.27
| Professional | | $252.39 | $307.93 | $425.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.97 / $406.41 / $628.17
| Professional | | $193.97 | $406.41 | $628.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.54 / $571.54 / $571.54
| Facility | | $571.54 | $571.54 | $571.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.02 / $313.79 / $452.03
| Professional | | $212.02 | $313.79 | $452.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,600.00 / $7,161.00
| Facility | | $55.00 | $1,600.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.50 / $462.76 / $1,714.73
| Professional | | $228.50 | $462.76 | $1,714.73 |
- 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
- $217.62 / $338.28 / $665.42
| Professional | | $217.62 | $338.28 | $665.42 |