- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.64 / $2,581.76 / $4,806.64
| Facility | | $265.64 | $2,581.76 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.13 / $325.50 / $815.68
| Professional | | $222.13 | $325.50 | $815.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.45 / $3,764.00 / $12,379.00
| Facility | | $572.45 | $3,764.00 | $12,379.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.92 / $552.91 / $2,137.60
| Professional | | $235.92 | $552.91 | $2,137.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.20 / $354.63 / $626.74
| Facility | | $273.20 | $354.63 | $626.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.20 / $508.66 / $730.84
| Professional | | $273.20 | $508.66 | $730.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.75 / $516.79 / $1,016.41
| Professional | | $296.75 | $516.79 | $1,016.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.33 / $498.18 / $6,679.00
| Facility | | $236.33 | $498.18 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.92 / $340.31 / $538.95
| Professional | | $184.92 | $340.31 | $538.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.99 / $627.27 / $885.51
| Professional | | $295.99 | $627.27 | $885.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.56 / $1,928.58 / $4,237.68
| Facility | | $724.56 | $1,928.58 | $4,237.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.97 / $348.50 / $677.78
| Professional | | $184.97 | $348.50 | $677.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,163.04 / $4,249.00 / $16,394.00
| Facility | | $1,163.04 | $4,249.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.04 / $674.24 / $2,137.60
| Professional | | $323.04 | $674.24 | $2,137.60 |
- 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
- $290.33 / $452.26 / $1,315.73
| Professional | | $290.33 | $452.26 | $1,315.73 |