- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $942.50 / $2,747.00 / $7,293.89
| Facility | | $942.50 | $2,747.00 | $7,293.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.47 / $310.64 / $1,035.00
| Professional | | $199.47 | $310.64 | $1,035.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.48 / $3,818.90 / $12,379.00
| Facility | | $476.48 | $3,818.90 | $12,379.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.23 / $386.57 / $1,656.00
| Professional | | $184.23 | $386.57 | $1,656.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.27 / $386.11 / $513.12
| Professional | | $294.27 | $386.11 | $513.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.30 / $396.38 / $730.91
| Professional | | $257.30 | $396.38 | $730.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.66 / $421.18 / $6,679.00
| Facility | | $200.66 | $421.18 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.24 / $225.75 / $363.95
| Professional | | $121.24 | $225.75 | $363.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.53 / $487.69 / $707.16
| Professional | | $244.53 | $487.69 | $707.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.56 / $3,191.93 / $4,556.76
| Facility | | $1,015.56 | $3,191.93 | $4,556.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.20 / $318.08 / $373.69
| Professional | | $310.20 | $318.08 | $373.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $4,525.00 / $16,394.00
| Facility | | $1,061.00 | $4,525.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.42 / $433.83 / $1,656.00
| Professional | | $225.42 | $433.83 | $1,656.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.00 / $4,249.00 / $9,821.00
| Facility | | $1,700.00 | $4,249.00 | $9,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.50 / $320.08 / $706.42
| Professional | | $218.50 | $320.08 | $706.42 |