- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.45 / $2,083.00 / $3,693.00
| Facility | | $119.45 | $2,083.00 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.29 / $125.17 / $410.77
| Professional | | $102.29 | $125.17 | $410.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.83 / $2,575.00 / $5,714.00
| Facility | | $264.83 | $2,575.00 | $5,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.31 / $266.19 / $1,581.00
| Professional | | $130.31 | $266.19 | $1,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.81 / $180.45 / $318.43
| Facility | | $138.81 | $180.45 | $318.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.68 / $258.00 / $541.71
| Professional | | $131.68 | $258.00 | $541.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.03 / $280.89 / $484.65
| Professional | | $150.03 | $280.89 | $484.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.45 / $214.32 / $6,679.00
| Facility | | $118.45 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.94 / $192.32 / $303.44
| Professional | | $105.94 | $192.32 | $303.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.52 / $314.18 / $453.77
| Professional | | $146.52 | $314.18 | $453.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,718.81 / $1,718.81 / $1,718.81
| Facility | | $1,718.81 | $1,718.81 | $1,718.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.50 / $171.50 / $183.40
| Professional | | $171.50 | $171.50 | $183.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,854.00 / $9,039.00
| Facility | | $55.00 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.07 / $313.12 / $1,581.00
| Professional | | $165.07 | $313.12 | $1,581.00 |
- 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
- $135.78 / $251.02 / $758.75
| Professional | | $135.78 | $251.02 | $758.75 |