- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.60 / $3,517.00 / $10,930.78
| Facility | | $420.60 | $3,517.00 | $10,930.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.41 / $264.81 / $548.94
| Professional | | $216.41 | $264.81 | $548.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.32 / $442.32 / $442.32
| Professional | | $442.32 | $442.32 | $442.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.55 / $252.74 / $556.87
| Professional | | $243.55 | $252.74 | $556.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.00 / $320.97 / $498.84
| Professional | | $243.00 | $320.97 | $498.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.57 / $373.79 / $374.20
| Professional | | $282.57 | $373.79 | $374.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,674.29 / $8,360.11 / $15,162.01
| Facility | | $2,674.29 | $8,360.11 | $15,162.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.24 / $3,517.00 / $9,562.10
| Facility | | $514.24 | $3,517.00 | $9,562.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.41 / $337.05 / $771.36
| Professional | | $229.41 | $337.05 | $771.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $501.90 / $626.50
| Professional | | $5.00 | $501.90 | $626.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.84 / $339.78 / $550.67
| Professional | | $253.84 | $339.78 | $550.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.99 / $236.99 / $441.60
| Facility | | $236.99 | $236.99 | $441.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.49 / $238.49 / $441.60
| Professional | | $229.49 | $238.49 | $441.60 |
- 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
- $241.20 / $312.95 / $504.70
| Professional | | $241.20 | $312.95 | $504.70 |