- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.20 / $3,077.00 / $7,927.19
| Facility | | $247.20 | $3,077.00 | $7,927.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.24 / $316.42 / $626.73
| Professional | | $151.24 | $316.42 | $626.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.60 / $524.62 / $615.66
| Professional | | $314.60 | $524.62 | $615.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.11 / $356.49 / $682.20
| Professional | | $185.11 | $356.49 | $682.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.45 / $570.70 / $584.04
| Professional | | $430.45 | $570.70 | $584.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,267.95 / $4,543.67 / $8,390.83
| Facility | | $1,267.95 | $4,543.67 | $8,390.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.50 / $3,222.64 / $8,017.00
| Facility | | $293.50 | $3,222.64 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.65 / $336.47 / $864.70
| Professional | | $158.65 | $336.47 | $864.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $352.40 / $1,055.90
| Professional | | $3.00 | $352.40 | $1,055.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.29 / $356.49 / $682.20
| Professional | | $187.29 | $356.49 | $682.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.97 / $163.71 / $375.86
| Facility | | $151.97 | $163.71 | $375.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.34 / $273.60 / $404.34
| Professional | | $158.34 | $273.60 | $404.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.00 / $2,391.00 / $4,789.00
| Facility | | $912.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.82 / $442.49 / $700.68
| Professional | | $315.82 | $442.49 | $700.68 |