- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.38 / $1,819.00 / $7,175.00
| Facility | | $182.38 | $1,819.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.83 / $188.73 / $329.63
| Professional | | $110.83 | $188.73 | $329.63 |
- 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
- $183.68 / $205.13 / $306.95
| Professional | | $183.68 | $205.13 | $306.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.52 / $211.74 / $365.39
| Professional | | $130.52 | $211.74 | $365.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.36 / $314.32 / $322.67
| Professional | | $237.36 | $314.32 | $322.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $949.26 / $1,689.93 / $3,777.20
| Facility | | $949.26 | $1,689.93 | $3,777.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.00 / $2,070.00 / $7,799.00
| Facility | | $428.00 | $2,070.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.73 / $202.95 / $431.57
| Professional | | $117.73 | $202.95 | $431.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $230.00 / $536.10
| Professional | | $3.00 | $230.00 | $536.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.69 / $213.66 / $377.18
| Professional | | $131.69 | $213.66 | $377.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.56 / $117.32 / $196.90
| Facility | | $112.56 | $117.32 | $196.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.30 / $192.67 / $209.84
| Professional | | $114.30 | $192.67 | $209.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.17 / $237.98 / $414.96
| Professional | | $184.17 | $237.98 | $414.96 |