- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.99 / $2,747.00 / $8,017.00
| Facility | | $161.99 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.54 / $143.13 / $296.05
| Professional | | $124.54 | $143.13 | $296.05 |
- 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
- $172.47 / $178.98 / $178.98
| Professional | | $172.47 | $178.98 | $178.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.50 / $184.84 / $309.95
| Professional | | $136.50 | $184.84 | $309.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.18 / $276.45 / $280.14
| Professional | | $208.18 | $276.45 | $280.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,883.01 / $2,883.01 / $11,938.27
| Facility | | $2,883.01 | $2,883.01 | $11,938.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $3,077.00 / $8,017.00
| Facility | | $657.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.12 / $169.18 / $484.91
| Professional | | $128.12 | $169.18 | $484.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $175.00 / $473.20
| Professional | | $3.00 | $175.00 | $473.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.69 / $191.27 / $314.02
| Professional | | $138.69 | $191.27 | $314.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.13 / $148.28 / $172.54
| Facility | | $143.13 | $148.28 | $172.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.86 / $152.49 / $184.85
| Professional | | $142.86 | $152.49 | $184.85 |
- 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
- $138.82 / $191.88 / $317.00
| Professional | | $138.82 | $191.88 | $317.00 |