- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.76 / $2,291.00 / $18,711.00
| Facility | | $210.76 | $2,291.00 | $18,711.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.19 / $150.49 / $313.66
| Professional | | $108.19 | $150.49 | $313.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,152.06 / $15,181.18 / $24,066.40
| Facility | | $4,152.06 | $15,181.18 | $24,066.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.08 / $283.58 / $1,029.68
| Professional | | $166.08 | $283.58 | $1,029.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $10,050.10
| Facility | | $466.83 | $568.48 | $10,050.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.56 / $218.89 / $348.53
| Professional | | $130.56 | $218.89 | $348.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.66 / $264.14 / $8,813.60
| Facility | | $132.66 | $264.14 | $8,813.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.11 / $245.05 / $6,771.29
| Professional | | $118.11 | $245.05 | $6,771.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.48 / $202.94 / $346.74
| Professional | | $33.48 | $202.94 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.90 / $224.81 / $234.50
| Facility | | $174.90 | $224.81 | $234.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.74 / $1,679.99 / $5,666.50
| Facility | | $156.74 | $1,679.99 | $5,666.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.57 / $264.02 / $318.68
| Professional | | $167.57 | $264.02 | $318.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,473.20 / $16,151.01 / $30,895.07
| Facility | | $10,473.20 | $16,151.01 | $30,895.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.11 / $230.09 / $302.14
| Professional | | $185.11 | $230.09 | $302.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $3,129.00 / $11,905.62
| Facility | | $1,300.00 | $3,129.00 | $11,905.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.07 / $204.61 / $335.03
| Professional | | $123.07 | $204.61 | $335.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.00 / $123.28 / $123.28
| Professional | | $98.00 | $123.28 | $123.28 |