- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.44 / $2,618.00 / $4,410.00
| Facility | | $225.44 | $2,618.00 | $4,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.00 / $317.23 / $570.85
| Professional | | $217.00 | $317.23 | $570.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.71 / $2,410.09 / $26,542.00
| Facility | | $578.71 | $2,410.09 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.72 / $633.54 / $2,818.32
| Professional | | $294.72 | $633.54 | $2,818.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.75 / $362.05 / $645.77
| Facility | | $281.75 | $362.05 | $645.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $462.04 / $785.89 / $1,620.25
| Professional | | $462.04 | $785.89 | $1,620.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.00 / $748.00 / $3,103.98
| Facility | | $680.00 | $748.00 | $3,103.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.76 / $518.74 / $1,026.33
| Professional | | $278.76 | $518.74 | $1,026.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.26 / $578.00 / $6,679.00
| Facility | | $241.26 | $578.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.54 / $589.84 / $843.71
| Professional | | $454.54 | $589.84 | $843.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.14 / $645.98 / $1,067.84
| Professional | | $344.14 | $645.98 | $1,067.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $26,542.00
| Facility | | $1,061.00 | $2,854.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.44 / $932.08 / $2,818.32
| Professional | | $379.44 | $932.08 | $2,818.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $5,714.00
| Facility | | $1,061.00 | $2,854.00 | $5,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.34 / $521.10 / $1,210.79
| Professional | | $351.34 | $521.10 | $1,210.79 |