- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $2,071.25 / $8,017.00
| Facility | | $480.00 | $2,071.25 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.62 / $556.04 / $1,408.13
| Professional | | $47.62 | $556.04 | $1,408.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $688.82 / $1,356.28 / $1,675.03
| Professional | | $688.82 | $1,356.28 | $1,675.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.26 / $145.13 / $1,557.17
| Professional | | $59.26 | $145.13 | $1,557.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $968.55 / $1,285.19 / $1,340.24
| Professional | | $968.55 | $1,285.19 | $1,340.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.54 / $243.49 / $1,146.03
| Facility | | $152.54 | $243.49 | $1,146.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,071.25 / $7,799.00
| Facility | | $540.00 | $2,071.25 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.77 / $641.00 / $1,634.43
| Professional | | $52.77 | $641.00 | $1,634.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,069.09 / $1,277.20 / $2,505.00
| Professional | | $1,069.09 | $1,277.20 | $2,505.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.21 / $145.13 / $1,557.17
| Professional | | $61.21 | $145.13 | $1,557.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $67.61 / $978.86
| Facility | | $48.98 | $67.61 | $978.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $810.87 / $908.46
| Professional | | $48.98 | $810.87 | $908.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $907.51 / $1,165.59 / $1,932.42
| Professional | | $907.51 | $1,165.59 | $1,932.42 |