- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.89 / $2,747.00 / $8,017.00
| Facility | | $224.89 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.79 / $190.94 / $269.50
| Professional | | $125.79 | $190.94 | $269.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.83 / $262.83 / $262.83
| Professional | | $262.83 | $262.83 | $262.83 |
- 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
- $223.07 / $231.48 / $368.84
| Professional | | $223.07 | $231.48 | $368.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.60 / $235.12 / $367.05
| Professional | | $159.60 | $235.12 | $367.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.20 / $367.14 / $367.14
| Professional | | $274.20 | $367.14 | $367.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,317.85 / $1,317.85 / $13,820.48
| Facility | | $1,317.85 | $1,317.85 | $13,820.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $3,077.00 / $8,017.00
| Facility | | $652.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.33 / $216.05 / $625.85
| Professional | | $134.33 | $216.05 | $625.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $216.00 / $608.90
| Professional | | $3.00 | $216.00 | $608.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.60 / $236.04 / $367.68
| Professional | | $159.60 | $236.04 | $367.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.24 / $149.28 / $225.18
| Facility | | $144.24 | $149.28 | $225.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.24 / $187.23 / $241.14
| Professional | | $144.24 | $187.23 | $241.14 |
- 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
- $181.88 / $260.92 / $422.47
| Professional | | $181.88 | $260.92 | $422.47 |