- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.53 / $1,823.00 / $3,363.00
| Facility | | $218.53 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.90 / $340.07 / $553.08
| Professional | | $204.90 | $340.07 | $553.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.68 / $1,689.00 / $12,000.00
| Facility | | $484.68 | $1,689.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.94 / $658.11 / $2,887.76
| Professional | | $302.94 | $658.11 | $2,887.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.02 / $379.10 / $676.19
| Facility | | $295.02 | $379.10 | $676.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $633.32 / $834.74 / $834.74
| Professional | | $633.32 | $834.74 | $834.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $865.37 / $2,000.00
| Facility | | $443.00 | $865.37 | $2,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.64 / $492.32 / $1,106.10
| Professional | | $266.64 | $492.32 | $1,106.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.90 / $436.50 / $6,679.00
| Facility | | $208.90 | $436.50 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $462.25 / $596.23 / $1,029.34
| Professional | | $462.25 | $596.23 | $1,029.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.99 / $566.13 / $1,092.13
| Professional | | $307.99 | $566.13 | $1,092.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.00 / $2,338.00 / $12,000.00
| Facility | | $822.00 | $2,338.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.94 / $1,008.64 / $2,887.76
| Professional | | $463.94 | $1,008.64 | $2,887.76 |
- 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
- $428.76 / $642.00 / $1,487.10
| Professional | | $428.76 | $642.00 | $1,487.10 |