- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.12 / $1,819.00 / $7,772.10
| Facility | | $216.12 | $1,819.00 | $7,772.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.79 / $216.12 / $393.72
| Professional | | $127.79 | $216.12 | $393.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.15 / $240.18 / $339.24
| Professional | | $204.15 | $240.18 | $339.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.11 / $262.02 / $438.48
| Professional | | $159.11 | $262.02 | $438.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.55 / $364.65 / $373.06
| Professional | | $275.55 | $364.65 | $373.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.35 / $4,326.97 / $7,528.99
| Facility | | $1,061.35 | $4,326.97 | $7,528.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.43 / $1,819.00 / $7,772.10
| Facility | | $266.43 | $1,819.00 | $7,772.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.28 / $248.29 / $692.77
| Professional | | $139.28 | $248.29 | $692.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $360.50 / $638.00
| Professional | | $4.00 | $360.50 | $638.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.11 / $270.57 / $464.06
| Professional | | $159.11 | $270.57 | $464.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.28 / $220.90 / $339.29
| Facility | | $139.28 | $220.90 | $339.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.28 / $228.81 / $249.06
| Professional | | $139.28 | $228.81 | $249.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.98 / $312.89 / $499.58
| Professional | | $231.98 | $312.89 | $499.58 |