- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.82 / $2,543.00 / $8,017.00
| Facility | | $227.82 | $2,543.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.38 / $281.39 / $740.71
| Professional | | $140.38 | $281.39 | $740.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.61 / $557.61 / $557.61
| Professional | | $557.61 | $557.61 | $557.61 |
- 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
- $300.73 / $312.08 / $451.73
| Professional | | $300.73 | $312.08 | $451.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.38 / $307.33 / $558.73
| Professional | | $173.38 | $307.33 | $558.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.37 / $484.15 / $490.36
| Professional | | $364.37 | $484.15 | $490.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,045.92 / $7,386.80 / $14,583.81
| Facility | | $3,045.92 | $7,386.80 | $14,583.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.12 / $2,605.00 / $8,017.00
| Facility | | $279.12 | $2,605.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.41 / $308.14 / $840.57
| Professional | | $149.41 | $308.14 | $840.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $240.50 / $852.20
| Professional | | $3.00 | $240.50 | $852.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.88 / $313.92 / $575.41
| Professional | | $174.88 | $313.92 | $575.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.18 / $185.13 / $307.00
| Facility | | $156.18 | $185.13 | $307.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.18 / $283.64 / $329.70
| Professional | | $156.18 | $283.64 | $329.70 |
- 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
- $286.55 / $388.68 / $647.59
| Professional | | $286.55 | $388.68 | $647.59 |