- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.73 / $2,067.00 / $3,625.00
| Facility | | $178.73 | $2,067.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.23 / $138.03 / $387.08
| Professional | | $66.23 | $138.03 | $387.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.72 / $1,275.80 / $3,472.00
| Facility | | $152.72 | $1,275.80 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.34 / $372.84 / $1,225.88
| Professional | | $74.34 | $372.84 | $1,225.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.64 / $98.18 / $195.43
| Facility | | $76.64 | $98.18 | $195.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.45 / $386.66 / $771.77
| Professional | | $107.45 | $386.66 | $771.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.06 / $204.85 / $743.10
| Professional | | $79.06 | $204.85 | $743.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.67 / $168.26 / $6,679.00
| Facility | | $77.67 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.63 / $359.57 / $584.29
| Professional | | $194.63 | $359.57 | $584.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.08 / $323.08 / $946.70
| Professional | | $94.08 | $323.08 | $946.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.91 / $1,706.04 / $1,827.94
| Facility | | $766.91 | $1,706.04 | $1,827.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.56 / $102.18 / $245.00
| Professional | | $101.56 | $102.18 | $245.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $1,600.00 / $4,142.00
| Facility | | $540.00 | $1,600.00 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.74 / $525.77 / $2,221.60
| Professional | | $213.74 | $525.77 | $2,221.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $898.25 / $1,930.00 / $4,142.00
| Facility | | $898.25 | $1,930.00 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.08 / $408.12 / $878.73
| Professional | | $212.08 | $408.12 | $878.73 |