- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.18 / $2,483.00 / $7,372.54
| Facility | | $234.18 | $2,483.00 | $7,372.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.03 / $200.96 / $359.14
| Professional | | $117.03 | $200.96 | $359.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,824.00 / $4,354.00 / $8,459.92
| Facility | | $1,824.00 | $4,354.00 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.09 / $215.94 / $215.94
| Professional | | $208.09 | $215.94 | $215.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.63 / $210.60 / $365.35
| Professional | | $128.63 | $210.60 | $365.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.03 / $335.40 / $346.07
| Professional | | $253.03 | $335.40 | $346.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.08 / $2,843.79 / $13,291.00
| Facility | | $1,480.08 | $2,843.79 | $13,291.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,422.00 / $7,799.00
| Facility | | $540.00 | $2,422.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.62 / $213.79 / $630.74
| Professional | | $121.62 | $213.79 | $630.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $177.80 / $587.79
| Professional | | $5.00 | $177.80 | $587.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.49 / $220.51 / $396.47
| Professional | | $132.49 | $220.51 | $396.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.59 / $137.33 / $210.01
| Facility | | $119.59 | $137.33 | $210.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.02 / $192.68 / $227.19
| Professional | | $119.02 | $192.68 | $227.19 |
- 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
- $169.28 / $232.45 / $406.06
| Professional | | $169.28 | $232.45 | $406.06 |