- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.78 / $1,978.00 / $7,197.00
| Facility | | $167.78 | $1,978.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.88 / $151.18 / $252.64
| Professional | | $131.88 | $151.18 | $252.64 |
- 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
- $178.90 / $185.65 / $185.65
| Professional | | $178.90 | $185.65 | $185.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.22 / $195.86 / $326.06
| Professional | | $147.22 | $195.86 | $326.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.68 / $284.88 / $288.48
| Professional | | $214.68 | $284.88 | $288.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,531.94 / $6,715.99 / $8,635.18
| Facility | | $2,531.94 | $6,715.99 | $8,635.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,266.00 / $7,799.00
| Facility | | $540.00 | $2,266.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.43 / $169.66 / $498.30
| Professional | | $141.43 | $169.66 | $498.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $209.40 / $487.80
| Professional | | $3.00 | $209.40 | $487.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.31 / $202.52 / $330.38
| Professional | | $148.31 | $202.52 | $330.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.33 / $153.38 / $179.15
| Facility | | $151.33 | $153.38 | $179.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.27 / $174.14 / $191.31
| Professional | | $151.27 | $174.14 | $191.31 |
- 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
- $149.34 / $196.36 / $324.66
| Professional | | $149.34 | $196.36 | $324.66 |