- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.98 / $2,079.00 / $3,685.00
| Facility | | $393.98 | $2,079.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.47 / $263.89 / $522.07
| Professional | | $74.47 | $263.89 | $522.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.16 / $3,006.00 / $7,608.00
| Facility | | $161.16 | $3,006.00 | $7,608.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.16 / $601.54 / $2,004.02
| Professional | | $87.16 | $601.54 | $2,004.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.79 / $102.21 / $203.46
| Facility | | $79.79 | $102.21 | $203.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.71 / $134.11 / $878.44
| Professional | | $28.71 | $134.11 | $878.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.59 / $240.81 / $1,052.85
| Professional | | $97.59 | $240.81 | $1,052.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.42 / $168.26 / $6,679.00
| Facility | | $81.42 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.30 / $621.03 / $938.29
| Professional | | $474.30 | $621.03 | $938.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.83 / $422.31 / $1,141.74
| Professional | | $98.83 | $422.31 | $1,141.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,672.59 / $1,672.59 / $6,902.88
| Facility | | $1,672.59 | $1,672.59 | $6,902.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.50 / $101.50 / $110.68
| Professional | | $101.50 | $101.50 | $110.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.75 / $3,110.00 / $7,608.00
| Facility | | $739.75 | $3,110.00 | $7,608.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $428.03 / $801.77 / $2,905.60
| Professional | | $428.03 | $801.77 | $2,905.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.62 / $646.62 / $1,423.72
| Professional | | $396.62 | $646.62 | $1,423.72 |