- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.96 / $1,473.20 / $3,363.00
| Facility | | $330.96 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.14 / $193.05 / $509.32
| Professional | | $79.14 | $193.05 | $509.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.20 / $1,339.09 / $3,804.00
| Facility | | $166.20 | $1,339.09 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.85 / $222.11 / $1,080.00
| Professional | | $82.85 | $222.11 | $1,080.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.66 / $113.96 / $223.53
| Facility | | $87.66 | $113.96 | $223.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.15 / $182.04 / $365.69
| Professional | | $83.15 | $182.04 | $365.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.82 / $226.17 / $442.45
| Professional | | $106.82 | $226.17 | $442.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $168.26 / $6,679.00
| Facility | | $83.43 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.84 / $174.08 / $280.64
| Professional | | $95.84 | $174.08 | $280.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.30 / $205.95 / $411.03
| Professional | | $95.30 | $205.95 | $411.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.10 / $618.84 / $1,865.99
| Facility | | $158.10 | $618.84 | $1,865.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.42 / $248.77 / $381.10
| Professional | | $118.42 | $248.77 | $381.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,878.00 / $7,161.00
| Facility | | $55.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.49 / $352.71 / $1,080.00
| Professional | | $170.49 | $352.71 | $1,080.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.22 / $225.82 / $467.12
| Professional | | $162.22 | $225.82 | $467.12 |