- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $2,570.40 / $7,762.47
| Facility | | $302.00 | $2,570.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $281.84 / $1,071.52
| Professional | | $120.23 | $281.84 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Professional | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $288.40 / $512.86
| Professional | | $194.98 | $288.40 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $436.52 / $478.63
| Professional | | $338.84 | $436.52 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $331.13 / $489.78
| Professional | | $181.97 | $331.13 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,238.72 / $4,786.30
| Facility | | $602.56 | $2,238.72 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $1,995.26 / $7,244.36
| Facility | | $302.00 | $1,995.26 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $323.59 / $776.25
| Professional | | $186.21 | $323.59 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $2,754.23 / $9,772.37
| Facility | | $199.53 | $2,754.23 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $501.19 / $630.96
| Professional | | $208.93 | $501.19 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $275.42 / $309.03
| Facility | | $181.97 | $275.42 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $275.42 / $309.03
| Professional | | $181.97 | $275.42 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,630.27 / $5,495.41
| Facility | | $912.01 | $2,630.27 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $257.04 / $446.68
| Professional | | $169.82 | $257.04 | $446.68 |