- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.91 / $2,083.00 / $3,693.00
| Facility | | $303.91 | $2,083.00 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.06 / $303.91 / $1,176.43
| Professional | | $204.06 | $303.91 | $1,176.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.20 / $2,329.00 / $5,803.32
| Facility | | $418.20 | $2,329.00 | $5,803.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.47 / $475.59 / $1,995.04
| Professional | | $208.47 | $475.59 | $1,995.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.28 / $283.76 / $500.73
| Facility | | $218.28 | $283.76 | $500.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.96 / $357.96 / $550.88
| Professional | | $357.96 | $357.96 | $550.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.83 / $510.79 / $905.02
| Professional | | $279.83 | $510.79 | $905.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.59 / $298.52 / $6,679.00
| Facility | | $183.59 | $298.52 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.75 / $404.04 / $722.40
| Professional | | $319.75 | $404.04 | $722.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.33 / $498.28 / $752.95
| Professional | | $231.33 | $498.28 | $752.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,641.30 / $2,641.30 / $2,742.60
| Facility | | $2,641.30 | $2,641.30 | $2,742.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.49 / $588.88 / $708.37
| Professional | | $500.49 | $588.88 | $708.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,376.00 / $8,498.00
| Facility | | $55.00 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.96 / $840.21 / $1,995.04
| Professional | | $336.96 | $840.21 | $1,995.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.99 / $444.28 / $1,092.73
| Professional | | $312.99 | $444.28 | $1,092.73 |