- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.72 / $2,747.00 / $8,017.00
| Facility | | $248.72 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.08 / $203.35 / $294.33
| Professional | | $167.08 | $203.35 | $294.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.48 / $237.10 / $237.10
| Professional | | $228.48 | $237.10 | $237.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.75 / $261.81 / $426.03
| Professional | | $195.75 | $261.81 | $426.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.95 / $360.95 / $362.28
| Professional | | $271.95 | $360.95 | $362.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,310.69 / $3,310.69 / $3,310.69
| Facility | | $3,310.69 | $3,310.69 | $3,310.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.33 / $236.09 / $987.78
| Professional | | $177.33 | $236.09 | $987.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $384.10 / $587.20
| Professional | | $3.00 | $384.10 | $587.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $201.44 / $269.89 / $433.79
| Professional | | $201.44 | $269.89 | $433.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.48 / $204.65 / $349.43
| Facility | | $184.48 | $204.65 | $349.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.48 / $217.26 / $236.25
| Professional | | $184.48 | $217.26 | $236.25 |
- 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
- $222.27 / $285.73 / $436.78
| Professional | | $222.27 | $285.73 | $436.78 |