- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.04 / $1,978.00 / $7,197.00
| Facility | | $226.04 | $1,978.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.96 / $196.43 / $301.29
| Professional | | $157.96 | $196.43 | $301.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $5,951.00 / $8,887.00
| Facility | | $2,800.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.87 / $249.96 / $351.71
| Professional | | $240.87 | $249.96 | $351.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.88 / $255.00 / $432.39
| Professional | | $185.88 | $255.00 | $432.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.06 / $385.32 / $388.76
| Professional | | $290.06 | $385.32 | $388.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,618.17 / $9,844.60 / $10,807.81
| Facility | | $7,618.17 | $9,844.60 | $10,807.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.55 / $2,070.00 / $7,799.00
| Facility | | $447.55 | $2,070.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.56 / $218.09 / $660.00
| Professional | | $164.56 | $218.09 | $660.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $272.10 / $657.50
| Professional | | $3.00 | $272.10 | $657.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.76 / $261.33 / $432.39
| Professional | | $186.76 | $261.33 | $432.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.70 / $239.57 / $267.69
| Facility | | $182.70 | $239.57 | $267.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.70 / $236.34 / $258.45
| Professional | | $182.70 | $236.34 | $258.45 |
- 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
- $200.78 / $267.88 / $469.08
| Professional | | $200.78 | $267.88 | $469.08 |