- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.96 / $2,747.00 / $8,017.00
| Facility | | $360.96 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.15 / $240.16 / $412.96
| Professional | | $131.15 | $240.16 | $412.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.04 / $313.43 / $427.34
| Professional | | $302.04 | $313.43 | $427.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.50 / $274.92 / $510.64
| Professional | | $144.50 | $274.92 | $510.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.09 / $492.52 / $508.76
| Professional | | $371.09 | $492.52 | $508.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $935.16 / $935.16 / $935.16
| Facility | | $935.16 | $935.16 | $935.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $3,077.00 / $8,017.00
| Facility | | $652.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.25 / $261.88 / $752.13
| Professional | | $131.25 | $261.88 | $752.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $152.00 / $903.40
| Professional | | $5.00 | $152.00 | $903.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.76 / $284.94 / $527.58
| Professional | | $152.76 | $284.94 | $527.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.22 / $146.66 / $313.27
| Facility | | $129.22 | $146.66 | $313.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.97 / $198.19 / $341.01
| Professional | | $143.97 | $198.19 | $341.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.81 / $327.92 / $570.21
| Professional | | $215.81 | $327.92 | $570.21 |