- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.64 / $1,803.00 / $3,363.00
| Facility | | $286.64 | $1,803.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.47 / $226.90 / $395.26
| Professional | | $89.47 | $226.90 | $395.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.35 / $2,410.09 / $12,000.00
| Facility | | $298.35 | $2,410.09 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.41 / $506.77 / $2,293.28
| Professional | | $153.41 | $506.77 | $2,293.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.29 / $141.72 / $281.24
| Facility | | $110.29 | $141.72 | $281.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.15 / $398.23 / $790.09
| Professional | | $144.15 | $398.23 | $790.09 |
- 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
- $127.43 / $304.27 / $902.62
| Professional | | $127.43 | $304.27 | $902.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.58 / $377.00 / $6,679.00
| Facility | | $95.58 | $377.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.53 / $490.14 / $695.21
| Professional | | $374.53 | $490.14 | $695.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.63 / $396.08 / $879.34
| Professional | | $142.63 | $396.08 | $879.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.79 / $2,854.00 / $12,000.00
| Facility | | $539.79 | $2,854.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.20 / $782.52 / $2,293.28
| Professional | | $321.20 | $782.52 | $2,293.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $3,715.00 / $8,766.00
| Facility | | $1,061.00 | $3,715.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.81 / $496.18 / $1,023.30
| Professional | | $294.81 | $496.18 | $1,023.30 |