- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.56 / $1,926.00 / $8,017.00
| Facility | | $154.56 | $1,926.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.52 / $119.46 / $272.72
| Professional | | $99.52 | $119.46 | $272.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.00 / $5,951.00 / $8,887.00
| Facility | | $2,450.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.84 / $167.95 / $167.95
| Professional | | $161.84 | $167.95 | $167.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.92 / $159.18 / $266.75
| Professional | | $108.92 | $159.18 | $266.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.64 / $261.11 / $266.33
| Professional | | $196.64 | $261.11 | $266.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,427.83 / $7,762.55 / $17,841.96
| Facility | | $1,427.83 | $7,762.55 | $17,841.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.54 / $2,070.00 / $8,017.00
| Facility | | $230.54 | $2,070.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.31 / $154.56 / $383.00
| Professional | | $101.31 | $154.56 | $383.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $153.40 / $455.20
| Professional | | $3.00 | $153.40 | $455.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.64 / $164.87 / $266.75
| Professional | | $111.64 | $164.87 | $266.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.25 / $112.78 / $163.05
| Facility | | $101.25 | $112.78 | $163.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.06 / $132.97 / $175.70
| Professional | | $110.06 | $132.97 | $175.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $2,824.00 / $4,815.00
| Facility | | $1,175.00 | $2,824.00 | $4,815.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.86 / $161.09 / $279.39
| Professional | | $118.86 | $161.09 | $279.39 |