- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.69 / $2,410.00 / $3,469.00
| Facility | | $166.69 | $2,410.00 | $3,469.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.44 / $174.05 / $424.66
| Professional | | $150.44 | $174.05 | $424.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.00 / $2,338.00 / $16,394.00
| Facility | | $432.00 | $2,338.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.85 / $310.85 / $2,157.98
| Professional | | $168.85 | $310.85 | $2,157.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.36 / $200.85 / $393.41
| Professional | | $115.36 | $200.85 | $393.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $652.29 / $1,923.56
| Facility | | $593.00 | $652.29 | $1,923.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.49 / $302.17 / $546.58
| Professional | | $183.49 | $302.17 | $546.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.62 / $506.00 / $6,679.00
| Facility | | $157.62 | $506.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.32 / $224.07 / $366.21
| Professional | | $177.32 | $224.07 | $366.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.51 / $380.01 / $479.47
| Professional | | $192.51 | $380.01 | $479.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.05 / $1,286.05 / $4,029.34
| Facility | | $1,286.05 | $1,286.05 | $4,029.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.06 / $167.26 / $321.67
| Professional | | $119.06 | $167.26 | $321.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.00 / $3,649.00 / $16,394.00
| Facility | | $822.00 | $3,649.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.85 / $322.87 / $2,157.98
| Professional | | $178.85 | $322.87 | $2,157.98 |
- 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
- $173.57 / $250.63 / $576.23
| Professional | | $173.57 | $250.63 | $576.23 |