- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.17 / $3,925.18 / $18,711.00
| Facility | | $305.17 | $3,925.18 | $18,711.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.94 / $232.85 / $463.41
| Professional | | $149.94 | $232.85 | $463.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,903.00 / $4,809.85 / $12,444.54
| Facility | | $2,903.00 | $4,809.85 | $12,444.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.54 / $389.12 / $1,553.70
| Professional | | $236.54 | $389.12 | $1,553.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,126.23 / $1,126.23 / $1,876.28
| Facility | | $1,126.23 | $1,126.23 | $1,876.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.98 / $349.44 / $501.05
| Professional | | $226.98 | $349.44 | $501.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.44 / $390.30 / $2,639.83
| Facility | | $216.44 | $390.30 | $2,639.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.46 / $375.76 / $1,264.15
| Professional | | $224.46 | $375.76 | $1,264.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.40 / $218.09 / $358.72
| Professional | | $34.40 | $218.09 | $358.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.82 / $325.83 / $354.28
| Facility | | $253.82 | $325.83 | $354.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.67 / $231.94 / $676.20
| Facility | | $226.67 | $231.94 | $676.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.07 / $378.10 / $464.90
| Professional | | $241.07 | $378.10 | $464.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,118.98 / $4,807.10 / $9,200.71
| Facility | | $3,118.98 | $4,807.10 | $9,200.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.54 / $326.20 / $439.21
| Professional | | $236.54 | $326.20 | $439.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,740.00 / $6,167.72 / $9,865.41
| Facility | | $3,740.00 | $6,167.72 | $9,865.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.76 / $348.31 / $491.40
| Professional | | $221.76 | $348.31 | $491.40 |