- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.34 / $2,675.00 / $8,017.00
| Facility | | $177.34 | $2,675.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.59 / $177.34 / $248.33
| Professional | | $127.59 | $177.34 | $248.33 |
- 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
- $196.29 / $203.70 / $290.41
| Professional | | $196.29 | $203.70 | $290.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.63 / $222.22 / $366.74
| Professional | | $146.63 | $222.22 | $366.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.59 / $310.81 / $316.64
| Professional | | $234.59 | $310.81 | $316.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,626.56 / $2,626.56 / $2,626.56
| Facility | | $2,626.56 | $2,626.56 | $2,626.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,077.00 / $8,017.00
| Facility | | $918.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.41 / $185.61 / $700.00
| Professional | | $129.41 | $185.61 | $700.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $325.30 / $517.20
| Professional | | $3.00 | $325.30 | $517.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.58 / $224.21 / $372.31
| Professional | | $148.58 | $224.21 | $372.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.36 / $159.27 / $312.02
| Facility | | $136.36 | $159.27 | $312.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.36 / $188.00 / $204.77
| Professional | | $136.36 | $188.00 | $204.77 |
- 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
- $189.31 / $239.19 / $381.05
| Professional | | $189.31 | $239.19 | $381.05 |