- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.79 / $1,932.00 / $3,469.00
| Facility | | $162.79 | $1,932.00 | $3,469.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.52 / $223.83 / $393.82
| Professional | | $157.52 | $223.83 | $393.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.00 / $2,410.09 / $16,394.00
| Facility | | $438.00 | $2,410.09 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.75 / $435.96 / $2,081.96
| Professional | | $197.75 | $435.96 | $2,081.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.63 / $255.24 / $455.26
| Facility | | $198.63 | $255.24 | $455.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.87 / $462.24 / $1,620.25
| Professional | | $162.87 | $462.24 | $1,620.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $652.29 / $3,103.98
| Facility | | $593.00 | $652.29 | $3,103.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.34 / $345.83 / $665.65
| Professional | | $198.34 | $345.83 | $665.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.01 / $506.00 / $6,679.00
| Facility | | $171.01 | $506.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.57 / $346.92 / $506.94
| Professional | | $269.57 | $346.92 | $506.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.76 / $456.42 / $637.80
| Professional | | $244.76 | $456.42 | $637.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.07 / $412.07 / $412.07
| Professional | | $412.07 | $412.07 | $412.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $16,394.00
| Facility | | $1,061.00 | $2,854.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.20 / $558.09 / $2,081.96
| Professional | | $265.20 | $558.09 | $2,081.96 |
- 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
- $239.24 / $363.56 / $795.60
| Professional | | $239.24 | $363.56 | $795.60 |