- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.56 / $3,570.00 / $10,893.00
| Facility | | $366.56 | $3,570.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.91 / $248.91 / $378.02
| Professional | | $220.91 | $248.91 | $378.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.62 / $280.51 / $390.82
| Professional | | $221.62 | $280.51 | $390.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.96 / $213.96 / $224.43
| Facility | | $213.96 | $213.96 | $224.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276.41 / $2,277.00 / $4,619.00
| Facility | | $276.41 | $2,277.00 | $4,619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.61 / $327.47 / $496.51
| Professional | | $250.61 | $327.47 | $496.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $1,300.00
| Facility | | $55.00 | $55.00 | $1,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,334.00 / $4,334.00 / $4,334.00
| Professional | | $4,334.00 | $4,334.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.62 / $302.04 / $542.47
| Facility | | $230.62 | $302.04 | $542.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.69 / $358.80 / $422.12
| Professional | | $269.69 | $358.80 | $422.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.01 / $421.50 / $877.45
| Professional | | $252.01 | $421.50 | $877.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.89 / $303.91 / $617.83
| Facility | | $231.89 | $303.91 | $617.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.99 / $348.79 / $604.66
| Professional | | $256.99 | $348.79 | $604.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $1,970.00 / $8,583.00
| Facility | | $385.00 | $1,970.00 | $8,583.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.37 / $268.67 / $420.72
| Professional | | $194.37 | $268.67 | $420.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.15 / $232.34 / $313.05
| Professional | | $200.15 | $232.34 | $313.05 |