- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.86 / $2,671.00 / $4,712.00
| Facility | | $335.86 | $2,671.00 | $4,712.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.56 / $335.86 / $880.70
| Professional | | $188.56 | $335.86 | $880.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.37 / $1,981.00 / $5,567.79
| Facility | | $424.37 | $1,981.00 | $5,567.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.26 / $529.59 / $2,470.64
| Professional | | $219.26 | $529.59 | $2,470.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.48 / $271.02 / $531.62
| Facility | | $208.48 | $271.02 | $531.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.00 / $463.14 / $859.82
| Professional | | $300.00 | $463.14 | $859.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.39 / $506.59 / $1,072.14
| Professional | | $256.39 | $506.59 | $1,072.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.48 / $380.14 / $6,679.00
| Facility | | $182.48 | $380.14 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.59 / $413.70 / $638.27
| Professional | | $216.59 | $413.70 | $638.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.91 / $499.00 / $940.28
| Professional | | $230.91 | $499.00 | $940.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.66 / $2,667.36 / $3,863.50
| Facility | | $148.66 | $2,667.36 | $3,863.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.20 / $541.69 / $617.26
| Professional | | $280.20 | $541.69 | $617.26 |
- 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
- $459.18 / $878.23 / $2,470.64
| Professional | | $459.18 | $878.23 | $2,470.64 |
- 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
- $420.51 / $553.63 / $1,128.51
| Professional | | $420.51 | $553.63 | $1,128.51 |