- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.47 / $3,839.00 / $8,240.00
| Facility | | $170.47 | $3,839.00 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.75 / $120.13 / $216.89
| Professional | | $99.75 | $120.13 | $216.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.37 / $184.77 / $232.73
| Professional | | $117.37 | $184.77 | $232.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.95 / $154.38 / $255.75
| Professional | | $113.95 | $154.38 | $255.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.66 / $186.54 / $189.53
| Professional | | $140.66 | $186.54 | $189.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.45 / $2,988.62 / $8,807.75
| Facility | | $222.45 | $2,988.62 | $8,807.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $463.00 / $4,173.29 / $8,404.00
| Facility | | $463.00 | $4,173.29 | $8,404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.33 / $136.13 / $373.77
| Professional | | $92.33 | $136.13 | $373.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $147.50 / $306.00
| Professional | | $5.00 | $147.50 | $306.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.09 / $157.61 / $273.66
| Professional | | $119.09 | $157.61 | $273.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.04 / $115.04 / $124.23
| Facility | | $115.04 | $115.04 | $124.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.49 / $115.04 / $124.23
| Professional | | $112.49 | $115.04 | $124.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.52 / $145.49 / $231.18
| Professional | | $98.52 | $145.49 | $231.18 |