- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.23 / $1,741.00 / $7,175.00
| Facility | | $224.23 | $1,741.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.11 / $211.02 / $365.98
| Professional | | $128.11 | $211.02 | $365.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.39 / $218.33 / $218.33
| Professional | | $210.39 | $218.33 | $218.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.31 / $238.18 / $387.01
| Professional | | $140.31 | $238.18 | $387.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.36 / $341.44 / $352.13
| Professional | | $257.36 | $341.44 | $352.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,147.41 / $4,044.18 / $5,496.30
| Facility | | $1,147.41 | $4,044.18 | $5,496.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.82 / $1,777.00 / $7,175.00
| Facility | | $241.82 | $1,777.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.97 / $224.96 / $613.32
| Professional | | $134.97 | $224.96 | $613.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $145.90 / $602.50
| Professional | | $5.00 | $145.90 | $602.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.69 / $238.64 / $406.95
| Professional | | $144.69 | $238.64 | $406.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.21 / $148.50 / $212.37
| Facility | | $138.21 | $148.50 | $212.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.04 / $209.48 / $230.44
| Professional | | $146.04 | $209.48 | $230.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.59 / $268.18 / $444.99
| Professional | | $173.59 | $268.18 | $444.99 |