- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.72 / $3,327.00 / $7,197.00
| Facility | | $329.72 | $3,327.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.19 / $194.44 / $468.27
| Professional | | $168.19 | $194.44 | $468.27 |
- 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
- $202.23 / $209.86 / $209.86
| Professional | | $202.23 | $209.86 | $209.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.70 / $248.74 / $392.75
| Professional | | $192.70 | $248.74 | $392.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.56 / $321.17 / $321.17
| Professional | | $241.56 | $321.17 | $321.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,135.94 / $6,378.57 / $10,238.09
| Facility | | $2,135.94 | $6,378.57 | $10,238.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.55 / $2,628.00 / $7,799.00
| Facility | | $362.55 | $2,628.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.18 / $282.81 / $569.70
| Professional | | $180.18 | $282.81 | $569.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $250.90 / $525.10
| Professional | | $3.00 | $250.90 | $525.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.71 / $252.53 / $412.22
| Professional | | $192.71 | $252.53 | $412.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.25 / $199.84 / $211.59
| Facility | | $184.25 | $199.84 | $211.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.25 / $200.27 / $211.72
| Professional | | $184.25 | $200.27 | $211.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,715.00 / $4,789.00
| Facility | | $1,175.00 | $2,715.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.03 / $245.09 / $392.72
| Professional | | $180.03 | $245.09 | $392.72 |