- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.88 / $2,094.00 / $3,685.00
| Facility | | $364.88 | $2,094.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.57 / $347.37 / $589.11
| Professional | | $225.57 | $347.37 | $589.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.00 / $3,245.00 / $12,000.00
| Facility | | $541.00 | $3,245.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.14 / $504.37 / $2,287.00
| Professional | | $233.14 | $504.37 | $2,287.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.24 / $407.93 / $579.78
| Professional | | $339.24 | $407.93 | $579.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $3,536.35
| Facility | | $443.00 | $500.00 | $3,536.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.89 / $448.58 / $797.24
| Professional | | $275.89 | $448.58 | $797.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.84 / $452.16 / $6,679.00
| Facility | | $216.84 | $452.16 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.95 / $308.26 / $551.14
| Professional | | $243.95 | $308.26 | $551.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.93 / $535.11 / $672.29
| Professional | | $269.93 | $535.11 | $672.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,928.58 / $1,928.58 / $5,753.39
| Facility | | $1,928.58 | $1,928.58 | $5,753.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.22 / $438.63 / $438.63
| Professional | | $320.22 | $438.63 | $438.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,019.00 / $5,572.00 / $12,000.00
| Facility | | $1,019.00 | $5,572.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.62 / $545.32 / $2,287.00
| Professional | | $262.62 | $545.32 | $2,287.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $4,287.00 / $8,810.00
| Facility | | $1,485.00 | $4,287.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.34 / $457.07 / $821.26
| Professional | | $248.34 | $457.07 | $821.26 |