- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.00 / $2,670.00 / $4,309.89
| Facility | | $699.00 | $2,670.00 | $4,309.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.87 / $324.07 / $950.00
| Professional | | $156.87 | $324.07 | $950.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.65 / $3,372.00 / $10,821.00
| Facility | | $360.65 | $3,372.00 | $10,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.49 / $512.78 / $3,913.13
| Professional | | $173.49 | $512.78 | $3,913.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.03 / $226.24 / $443.78
| Facility | | $174.03 | $226.24 | $443.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.71 / $472.77 / $1,150.38
| Professional | | $221.71 | $472.77 | $1,150.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.14 / $508.08 / $989.25
| Professional | | $225.14 | $508.08 | $989.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.96 / $317.32 / $6,679.00
| Facility | | $151.96 | $317.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.13 / $373.84 / $570.23
| Professional | | $194.13 | $373.84 | $570.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.61 / $411.90 / $834.78
| Professional | | $190.61 | $411.90 | $834.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $947.20 / $3,191.93 / $5,235.96
| Facility | | $947.20 | $3,191.93 | $5,235.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.25 / $241.79 / $460.56
| Professional | | $110.25 | $241.79 | $460.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $777.93 / $3,649.00 / $16,394.00
| Facility | | $777.93 | $3,649.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.48 / $827.40 / $3,913.13
| Professional | | $432.48 | $827.40 | $3,913.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.70 / $620.55 / $1,117.65
| Professional | | $396.70 | $620.55 | $1,117.65 |