- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $324.13 / $3,669.60 / $7,197.00
| Facility | | $324.13 | $3,669.60 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.78 / $299.94 / $576.88
| Professional | | $162.78 | $299.94 | $576.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.49 / $334.49 / $624.28
| Professional | | $334.49 | $334.49 | $624.28 |
- 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
- $297.43 / $422.25 / $584.62
| Professional | | $297.43 | $422.25 | $584.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.24 / $344.26 / $640.91
| Professional | | $200.24 | $344.26 | $640.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.37 / $541.22 / $547.20
| Professional | | $407.37 | $541.22 | $547.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,176.31 / $7,128.07 / $12,489.34
| Facility | | $2,176.31 | $7,128.07 | $12,489.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $3,689.00 / $7,799.00
| Facility | | $540.00 | $3,689.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.57 / $327.83 / $836.23
| Professional | | $173.57 | $327.83 | $836.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $413.80 / $946.60
| Professional | | $3.00 | $413.80 | $946.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.21 / $355.22 / $656.15
| Professional | | $202.21 | $355.22 | $656.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.90 / $206.05 / $342.73
| Facility | | $179.90 | $206.05 | $342.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.90 / $320.77 / $367.30
| Professional | | $179.90 | $320.77 | $367.30 |
- 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
- $318.20 / $426.66 / $673.91
| Professional | | $318.20 | $426.66 | $673.91 |