- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.00 / $2,581.76 / $4,509.53
| Facility | | $559.00 | $2,581.76 | $4,509.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.37 / $285.80 / $735.10
| Professional | | $137.37 | $285.80 | $735.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.36 / $3,764.00 / $12,379.00
| Facility | | $314.36 | $3,764.00 | $12,379.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.38 / $467.85 / $3,552.73
| Professional | | $145.38 | $467.85 | $3,552.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.88 / $198.74 / $389.84
| Facility | | $152.88 | $198.74 | $389.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.77 / $439.86 / $1,070.31
| Professional | | $194.77 | $439.86 | $1,070.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.91 / $445.41 / $934.77
| Professional | | $196.91 | $445.41 | $934.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.34 / $300.00 / $6,679.00
| Facility | | $133.34 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.62 / $347.82 / $529.47
| Professional | | $180.62 | $347.82 | $529.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.10 / $361.09 / $773.86
| Professional | | $167.10 | $361.09 | $773.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,103.34 / $3,863.69 / $5,235.96
| Facility | | $3,103.34 | $3,863.69 | $5,235.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.49 / $206.98 / $538.47
| Professional | | $103.49 | $206.98 | $538.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.32 / $4,249.00 / $16,394.00
| Facility | | $652.32 | $4,249.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.88 / $770.31 / $3,552.73
| Professional | | $372.88 | $770.31 | $3,552.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.64 / $498.19 / $1,056.08
| Professional | | $348.64 | $498.19 | $1,056.08 |