- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.24 / $2,679.00 / $8,017.00
| Facility | | $422.24 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.01 / $338.07 / $574.51
| Professional | | $143.01 | $338.07 | $574.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.79 / $352.62 / $352.62
| Professional | | $339.79 | $352.62 | $352.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.39 / $358.10 / $711.15
| Professional | | $172.39 | $358.10 | $711.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.00 / $254.38 / $544.80
| Professional | | $72.00 | $254.38 | $544.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,178.52 / $3,058.22 / $3,176.59
| Facility | | $1,178.52 | $3,058.22 | $3,176.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $2,679.00 / $8,017.00
| Facility | | $652.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.82 / $342.94 / $785.37
| Professional | | $152.82 | $342.94 | $785.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $289.00 / $1,021.70
| Professional | | $3.00 | $289.00 | $1,021.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.13 / $370.41 / $719.42
| Professional | | $176.13 | $370.41 | $719.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.82 / $361.70 / $583.37
| Facility | | $156.82 | $361.70 | $583.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.82 / $355.79 / $389.52
| Professional | | $156.82 | $355.79 | $389.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.00 / $3,000.00 / $6,593.34
| Facility | | $582.00 | $3,000.00 | $6,593.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.74 / $470.18 / $749.06
| Professional | | $352.74 | $470.18 | $749.06 |