- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.32 / $2,747.00 / $8,017.00
| Facility | | $309.32 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.26 / $274.83 / $441.67
| Professional | | $193.26 | $274.83 | $441.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.81 / $299.70 / $299.70
| Professional | | $288.81 | $299.70 | $299.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.02 / $323.70 / $555.46
| Professional | | $211.02 | $323.70 | $555.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.30 / $459.87 / $472.98
| Professional | | $347.30 | $459.87 | $472.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,383.06 / $1,383.06 / $1,383.06
| Facility | | $1,383.06 | $1,383.06 | $1,383.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,077.00 / $8,017.00
| Facility | | $918.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.04 / $307.39 / $1,056.00
| Professional | | $194.04 | $307.39 | $1,056.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $233.20 / $770.30
| Professional | | $5.00 | $233.20 | $770.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.64 / $327.97 / $565.07
| Professional | | $227.64 | $327.97 | $565.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.96 / $238.88 / $332.87
| Facility | | $191.96 | $238.88 | $332.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.20 / $276.19 / $301.31
| Professional | | $191.20 | $276.19 | $301.31 |
- 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
- $258.99 / $359.70 / $585.73
| Professional | | $258.99 | $359.70 | $585.73 |