- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.00 / $1,864.00 / $3,685.00
| Facility | | $537.00 | $1,864.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.00 / $285.92 / $811.01
| Professional | | $151.00 | $285.92 | $811.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.41 / $2,411.51 / $10,821.00
| Facility | | $514.41 | $2,411.51 | $10,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.04 / $520.39 / $1,996.64
| Professional | | $219.04 | $520.39 | $1,996.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.96 / $314.55 / $555.05
| Facility | | $241.96 | $314.55 | $555.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.79 / $396.79 / $556.27
| Professional | | $396.79 | $396.79 | $556.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.80 / $552.58 / $887.09
| Professional | | $305.80 | $552.58 | $887.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.88 / $1,349.66 / $6,679.00
| Facility | | $205.88 | $1,349.66 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.80 / $406.64 / $727.04
| Professional | | $321.80 | $406.64 | $727.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.58 / $543.74 / $757.50
| Professional | | $253.58 | $543.74 | $757.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.43 / $5,180.09 / $6,026.93
| Facility | | $0.43 | $5,180.09 | $6,026.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $498.23 / $498.23 / $515.17
| Professional | | $498.23 | $498.23 | $515.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,377.42 / $3,649.00 / $12,000.00
| Facility | | $1,377.42 | $3,649.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.92 / $699.69 / $1,996.64
| Professional | | $316.92 | $699.69 | $1,996.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.77 / $444.11 / $895.71
| Professional | | $301.77 | $444.11 | $895.71 |