- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.60 / $9,639.00 / $20,509.00
| Facility | | $285.60 | $9,639.00 | $20,509.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.54 / $304.63 / $1,479.96
| Professional | | $267.54 | $304.63 | $1,479.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,403.00 / $8,971.00 / $18,030.00
| Facility | | $3,403.00 | $8,971.00 | $18,030.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.84 / $591.26 / $1,029.15
| Professional | | $425.84 | $591.26 | $1,029.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.50 / $100.00 / $1,693.95
| Facility | | $63.50 | $100.00 | $1,693.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.41 / $339.15 / $710.23
| Professional | | $238.41 | $339.15 | $710.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.33 / $346.73 / $874.72
| Professional | | $280.33 | $346.73 | $874.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.67 / $271.38 / $325.66
| Professional | | $200.67 | $271.38 | $325.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.24 / $314.10 / $588.54
| Professional | | $244.24 | $314.10 | $588.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,704.68 / $3,348.18
| Facility | | $55.00 | $2,704.68 | $3,348.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,866.32 / $1,914.64 / $2,258.33
| Professional | | $1,866.32 | $1,914.64 | $2,258.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.70 / $321.14 / $437.20
| Facility | | $259.70 | $321.14 | $437.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.73 / $346.73 / $804.39
| Professional | | $278.73 | $346.73 | $804.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $859.73 / $859.73 / $859.73
| Professional | | $859.73 | $859.73 | $859.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,047.00 / $5,319.00 / $20,279.00
| Facility | | $2,047.00 | $5,319.00 | $20,279.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.39 / $345.61 / $882.25
| Professional | | $229.39 | $345.61 | $882.25 |