- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.54 / $3,623.00 / $8,113.00
| Facility | | $253.54 | $3,623.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.37 / $232.64 / $436.91
| Professional | | $180.37 | $232.64 | $436.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.68 / $184.68 / $184.68
| Professional | | $184.68 | $184.68 | $184.68 |
- 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
- $271.49 / $281.73 / $281.73
| Professional | | $271.49 | $281.73 | $281.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.20 / $287.95 / $485.51
| Professional | | $212.20 | $287.95 | $485.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.45 / $433.58 / $437.36
| Professional | | $326.45 | $433.58 | $437.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,903.40 / $4,382.85 / $8,448.20
| Facility | | $2,903.40 | $4,382.85 | $8,448.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.24 / $3,748.00 / $8,017.00
| Facility | | $682.24 | $3,748.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.16 / $253.69 / $700.00
| Professional | | $191.16 | $253.69 | $700.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $221.30 / $736.10
| Professional | | $3.00 | $221.30 | $736.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.28 / $299.77 / $494.08
| Professional | | $215.28 | $299.77 | $494.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.61 / $208.88 / $271.48
| Facility | | $205.61 | $208.88 | $271.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.61 / $230.76 / $289.89
| Professional | | $205.61 | $230.76 | $289.89 |
- 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
- $223.38 / $304.79 / $498.66
| Professional | | $223.38 | $304.79 | $498.66 |