- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.78 / $2,747.00 / $5,219.91
| Facility | | $467.78 | $2,747.00 | $5,219.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.97 / $254.30 / $846.70
| Professional | | $190.97 | $254.30 | $846.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.39 / $2,628.00 / $26,542.00
| Facility | | $539.39 | $2,628.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.08 / $407.46 / $1,567.36
| Professional | | $222.08 | $407.46 | $1,567.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.01 / $780.05 / $1,620.25
| Professional | | $212.01 | $780.05 | $1,620.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.00 / $920.70 / $3,103.98
| Facility | | $837.00 | $920.70 | $3,103.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.83 / $383.75 / $672.73
| Professional | | $214.83 | $383.75 | $672.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.33 / $578.00 / $6,679.00
| Facility | | $221.33 | $578.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.00 / $318.22 / $462.19
| Professional | | $249.00 | $318.22 | $462.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.47 / $527.99 / $681.78
| Professional | | $267.47 | $527.99 | $681.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.05 / $4,385.22 / $5,954.84
| Facility | | $884.05 | $4,385.22 | $5,954.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.09 / $504.64 / $678.26
| Professional | | $374.09 | $504.64 | $678.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $4,249.00 / $26,542.00
| Facility | | $1,061.00 | $4,249.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.28 / $407.46 / $1,567.36
| Professional | | $233.28 | $407.46 | $1,567.36 |
- 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
- $217.22 / $326.93 / $714.63
| Professional | | $217.22 | $326.93 | $714.63 |