- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.31 / $2,747.00 / $8,017.00
| Facility | | $234.31 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.34 / $246.23 / $388.38
| Professional | | $146.34 | $246.23 | $388.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.97 / $292.61 / $292.61
| Professional | | $281.97 | $292.61 | $292.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.82 / $272.82 / $272.82
| Facility | | $272.82 | $272.82 | $272.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.72 / $259.01 / $459.66
| Professional | | $155.72 | $259.01 | $459.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.86 / $458.98 / $588.75
| Professional | | $340.86 | $458.98 | $588.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.04 / $3,839.00 / $8,427.00
| Facility | | $415.04 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.97 / $259.31 / $577.89
| Professional | | $150.97 | $259.31 | $577.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.30 / $216.30 / $562.10
| Professional | | $216.30 | $216.30 | $562.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.82 / $272.82 / $272.82
| Facility | | $272.82 | $272.82 | $272.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.94 / $266.01 / $489.16
| Professional | | $156.94 | $266.01 | $489.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.33 / $155.41 / $265.45
| Facility | | $144.33 | $155.41 | $265.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.80 / $199.76 / $286.27
| Professional | | $150.80 | $199.76 | $286.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.49 / $315.64 / $519.34
| Professional | | $221.49 | $315.64 | $519.34 |