- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.37 / $2,381.00 / $6,216.39
| Facility | | $301.37 | $2,381.00 | $6,216.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.99 / $231.63 / $438.43
| Professional | | $126.99 | $231.63 | $438.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.35 / $47.35 / $47.35
| Professional | | $47.35 | $47.35 | $47.35 |
- 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
- $235.13 / $276.62 / $617.78
| Professional | | $235.13 | $276.62 | $617.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.05 / $260.16 / $482.51
| Professional | | $147.05 | $260.16 | $482.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.75 / $421.53 / $434.83
| Professional | | $318.75 | $421.53 | $434.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,167.21 / $3,752.89 / $7,352.05
| Facility | | $1,167.21 | $3,752.89 | $7,352.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.26 / $2,421.31 / $6,929.22
| Facility | | $369.26 | $2,421.31 | $6,929.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.63 / $272.38 / $499.44
| Professional | | $129.63 | $272.38 | $499.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $291.50 / $765.90
| Professional | | $6.00 | $291.50 | $765.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.47 / $287.07 / $509.78
| Professional | | $147.47 | $287.07 | $509.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.18 / $248.76 / $384.24
| Facility | | $127.18 | $248.76 | $384.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.18 / $260.10 / $283.22
| Professional | | $127.18 | $260.10 | $283.22 |
- 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
- $236.14 / $338.70 / $560.85
| Professional | | $236.14 | $338.70 | $560.85 |