- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.82 / $1,823.00 / $3,363.00
| Facility | | $126.82 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.08 / $187.79 / $322.45
| Professional | | $116.08 | $187.79 | $322.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.75 / $1,089.00 / $5,047.31
| Facility | | $138.75 | $1,089.00 | $5,047.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.72 / $347.37 / $1,573.12
| Professional | | $173.72 | $347.37 | $1,573.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.66 / $189.74 / $338.73
| Facility | | $147.66 | $189.74 | $338.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.07 / $1,620.25 / $1,620.25
| Professional | | $121.07 | $1,620.25 | $1,620.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.80 / $358.58 / $748.00
| Facility | | $284.80 | $358.58 | $748.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.16 / $295.56 / $599.75
| Professional | | $157.16 | $295.56 | $599.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.60 / $214.32 / $6,679.00
| Facility | | $123.60 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.08 / $330.71 / $476.52
| Professional | | $254.08 | $330.71 | $476.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.83 / $335.68 / $594.26
| Professional | | $178.83 | $335.68 | $594.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,250.79 / $5,250.79 / $5,250.79
| Facility | | $5,250.79 | $5,250.79 | $5,250.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,640.00 / $4,755.00
| Facility | | $55.00 | $1,640.00 | $4,755.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.48 / $533.42 / $1,573.12
| Professional | | $231.48 | $533.42 | $1,573.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.00 / $2,338.00 / $4,952.00
| Facility | | $669.00 | $2,338.00 | $4,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.72 / $330.90 / $834.43
| Professional | | $211.72 | $330.90 | $834.43 |