- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.12 / $3,607.00 / $8,017.00
| Facility | | $271.12 | $3,607.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.74 / $259.75 / $508.70
| Professional | | $196.74 | $259.75 | $508.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.48 / $427.48 / $540.64
| Professional | | $427.48 | $427.48 | $540.64 |
- 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
- $293.10 / $304.16 / $477.53
| Professional | | $293.10 | $304.16 | $477.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.12 / $309.95 / $530.58
| Professional | | $230.12 | $309.95 | $530.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.71 / $467.32 / $469.31
| Professional | | $351.71 | $467.32 | $469.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,377.35 / $6,844.20 / $14,114.42
| Facility | | $2,377.35 | $6,844.20 | $14,114.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.17 / $3,245.00 / $8,017.00
| Facility | | $387.17 | $3,245.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.97 / $307.95 / $722.13
| Professional | | $209.97 | $307.95 | $722.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $333.50 / $783.40
| Professional | | $3.00 | $333.50 | $783.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.96 / $322.38 / $541.48
| Professional | | $232.96 | $322.38 | $541.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.24 / $264.69 / $306.45
| Facility | | $229.24 | $264.69 | $306.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.24 / $284.24 / $310.48
| Professional | | $229.24 | $284.24 | $310.48 |
- 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
- $243.73 / $342.87 / $549.16
| Professional | | $243.73 | $342.87 | $549.16 |