- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.57 / $2,747.00 / $8,169.44
| Facility | | $211.57 | $2,747.00 | $8,169.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.31 / $187.36 / $282.26
| Professional | | $148.31 | $187.36 | $282.26 |
- 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
- $224.80 / $233.29 / $409.11
| Professional | | $224.80 | $233.29 | $409.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.36 / $231.88 / $402.35
| Professional | | $169.36 | $231.88 | $402.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.02 / $360.12 / $362.98
| Professional | | $271.02 | $360.12 | $362.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,027.20 / $6,357.35 / $7,025.80
| Facility | | $2,027.20 | $6,357.35 | $7,025.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $628.36 / $3,077.00 / $8,247.00
| Facility | | $628.36 | $3,077.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.94 / $219.74 / $460.72
| Professional | | $155.94 | $219.74 | $460.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $229.50 / $615.40
| Professional | | $3.00 | $229.50 | $615.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.97 / $239.00 / $402.35
| Professional | | $174.97 | $239.00 | $402.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.25 / $202.48 / $226.53
| Facility | | $170.25 | $202.48 | $226.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.25 / $221.37 / $242.21
| Professional | | $170.25 | $221.37 | $242.21 |
- 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
- $183.18 / $249.40 / $419.44
| Professional | | $183.18 | $249.40 | $419.44 |