- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.00 / $2,663.12 / $4,432.10
| Facility | | $699.00 | $2,663.12 | $4,432.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.22 / $229.38 / $661.62
| Professional | | $118.22 | $229.38 | $661.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.61 / $2,376.00 / $8,498.00
| Facility | | $222.61 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.08 / $328.09 / $1,658.00
| Professional | | $108.08 | $328.09 | $1,658.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.24 / $141.66 / $281.11
| Facility | | $110.24 | $141.66 | $281.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.77 / $273.62 / $442.04
| Professional | | $180.77 | $273.62 | $442.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.80 / $281.36 / $587.62
| Professional | | $132.80 | $281.36 | $587.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.80 / $300.00 / $6,679.00
| Facility | | $95.80 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.73 / $305.89 / $424.27
| Professional | | $250.73 | $305.89 | $424.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.86 / $269.20 / $622.46
| Professional | | $128.86 | $269.20 | $622.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,125.81 / $3,000.00 / $6,101.99
| Facility | | $1,125.81 | $3,000.00 | $6,101.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.10 / $384.17 / $428.46
| Professional | | $295.10 | $384.17 | $428.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $649.79 / $3,372.00 / $16,394.00
| Facility | | $649.79 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.98 / $462.19 / $1,658.00
| Professional | | $273.98 | $462.19 | $1,658.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,450.00 / $3,592.00 / $8,498.00
| Facility | | $1,450.00 | $3,592.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.93 / $387.74 / $731.18
| Professional | | $260.93 | $387.74 | $731.18 |