- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.25 / $1,823.00 / $3,363.00
| Facility | | $100.25 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.62 / $153.11 / $263.41
| Professional | | $93.62 | $153.11 | $263.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.99 / $2,410.09 / $12,000.00
| Facility | | $313.99 | $2,410.09 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.90 / $322.00 / $1,497.36
| Professional | | $147.90 | $322.00 | $1,497.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.21 / $190.45 / $339.70
| Facility | | $148.21 | $190.45 | $339.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $633.32 / $1,695.28 / $1,695.28
| Professional | | $633.32 | $1,695.28 | $1,695.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $3,111.82
| Facility | | $443.00 | $500.00 | $3,111.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.89 / $252.50 / $547.75
| Professional | | $120.89 | $252.50 | $547.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.60 / $377.00 / $6,679.00
| Facility | | $100.60 | $377.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.74 / $314.75 / $455.80
| Professional | | $242.74 | $314.75 | $455.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.05 / $276.80 / $575.63
| Professional | | $150.05 | $276.80 | $575.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.40 / $2,854.00 / $12,000.00
| Facility | | $568.40 | $2,854.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.49 / $512.29 / $1,497.36
| Professional | | $209.49 | $512.29 | $1,497.36 |
- 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
- $192.92 / $324.24 / $679.05
| Professional | | $192.92 | $324.24 | $679.05 |