- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.00 / $2,180.00 / $7,317.00
| Facility | | $316.00 | $2,180.00 | $7,317.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.27 / $203.40 / $407.27
| Professional | | $119.27 | $203.40 | $407.27 |
- 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
- $191.90 / $227.08 / $327.29
| Professional | | $191.90 | $227.08 | $327.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.19 / $217.24 / $382.56
| Professional | | $135.19 | $217.24 | $382.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.97 / $306.23 / $312.61
| Professional | | $230.97 | $306.23 | $312.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.00 / $1,525.31 / $1,984.85
| Facility | | $406.00 | $1,525.31 | $1,984.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.00 / $2,543.00 / $8,017.00
| Facility | | $574.00 | $2,543.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.28 / $227.55 / $460.60
| Professional | | $125.28 | $227.55 | $460.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $244.60 / $525.10
| Professional | | $6.00 | $244.60 | $525.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.16 / $226.15 / $405.48
| Professional | | $137.16 | $226.15 | $405.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.60 / $164.32 / $244.54
| Facility | | $116.60 | $164.32 | $244.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.60 / $189.15 / $206.71
| Professional | | $116.60 | $189.15 | $206.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $557.00 / $3,742.00
| Facility | | $162.00 | $557.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.49 / $236.41 / $391.60
| Professional | | $167.49 | $236.41 | $391.60 |