- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.28 / $2,865.00 / $7,839.00
| Facility | | $232.28 | $2,865.00 | $7,839.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.65 / $282.58 / $544.36
| Professional | | $144.65 | $282.58 | $544.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.48 / $296.91 / $756.26
| Professional | | $236.48 | $296.91 | $756.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.19 / $220.19 / $4,050.00
| Facility | | $220.19 | $220.19 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.19 / $220.19 / $492.82
| Professional | | $220.19 | $220.19 | $492.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.65 / $243.65 / $14,648.00
| Facility | | $243.65 | $243.65 | $14,648.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.49 / $352.17 / $940.11
| Professional | | $162.49 | $352.17 | $940.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.66 / $236.67 / $520.97
| Facility | | $147.66 | $236.67 | $520.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.08 / $421.69 / $632.54
| Professional | | $311.08 | $421.69 | $632.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.24 / $351.95 / $651.39
| Professional | | $264.24 | $351.95 | $651.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.65 / $243.65 / $37,776.00
| Facility | | $243.65 | $243.65 | $37,776.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.04 / $411.32 / $1,041.88
| Professional | | $173.04 | $411.32 | $1,041.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,079.00 / $2,884.00 / $4,840.00
| Facility | | $1,079.00 | $2,884.00 | $4,840.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.89 / $442.87 / $938.16
| Professional | | $315.89 | $442.87 | $938.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.73 / $165.73 / $785.40
| Facility | | $165.73 | $165.73 | $785.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.83 / $375.46 / $651.39
| Professional | | $281.83 | $375.46 | $651.39 |