- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.77 / $1,473.20 / $3,363.00
| Facility | | $184.77 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.70 / $170.87 / $316.04
| Professional | | $100.70 | $170.87 | $316.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.85 / $1,177.70 / $7,161.00
| Facility | | $261.85 | $1,177.70 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.02 / $280.70 / $1,240.00
| Professional | | $127.02 | $280.70 | $1,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.88 / $166.91 / $297.97
| Facility | | $129.88 | $166.91 | $297.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.26 / $288.55 / $722.05
| Professional | | $176.26 | $288.55 | $722.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.50 / $242.08 / $433.29
| Professional | | $149.50 | $242.08 | $433.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.71 / $300.00 / $6,679.00
| Facility | | $113.71 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.11 / $232.71 / $319.49
| Professional | | $192.11 | $232.71 | $319.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.79 / $306.55 / $512.12
| Professional | | $145.79 | $306.55 | $512.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.36 / $783.39 / $3,863.50
| Facility | | $667.36 | $783.39 | $3,863.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.57 / $318.55 / $346.39
| Professional | | $180.57 | $318.55 | $346.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.41 / $2,078.00 / $12,000.00
| Facility | | $555.41 | $2,078.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.95 / $379.29 / $1,240.00
| Professional | | $195.95 | $379.29 | $1,240.00 |
- 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
- $188.97 / $280.70 / $510.23
| Professional | | $188.97 | $280.70 | $510.23 |