- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.43 / $2,547.00 / $4,225.72
| Facility | | $298.43 | $2,547.00 | $4,225.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.30 / $298.43 / $766.89
| Professional | | $164.30 | $298.43 | $766.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.01 / $2,575.00 / $5,714.00
| Facility | | $351.01 | $2,575.00 | $5,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.44 / $474.28 / $2,206.23
| Professional | | $184.44 | $474.28 | $2,206.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.44 / $238.47 / $467.77
| Facility | | $183.44 | $238.47 | $467.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.70 / $473.39 / $993.98
| Professional | | $233.70 | $473.39 | $993.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.03 / $455.65 / $953.89
| Professional | | $202.03 | $455.65 | $953.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.99 / $250.88 / $6,679.00
| Facility | | $159.99 | $250.88 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.39 / $374.34 / $571.45
| Professional | | $194.39 | $374.34 | $571.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $201.95 / $436.40 / $840.24
| Professional | | $201.95 | $436.40 | $840.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.35 / $1,473.09 / $3,217.35
| Facility | | $505.35 | $1,473.09 | $3,217.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.77 / $256.83 / $528.58
| Professional | | $243.77 | $256.83 | $528.58 |
- 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
- $382.92 / $740.47 / $2,206.23
| Professional | | $382.92 | $740.47 | $2,206.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.47 / $468.07 / $1,004.05
| Professional | | $378.47 | $468.07 | $1,004.05 |