- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.80 / $538.20 / $2,747.00
| Facility | | $220.80 | $538.20 | $2,747.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.57 / $151.44 / $390.60
| Professional | | $99.57 | $151.44 | $390.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.62 / $1,177.70 / $3,472.00
| Facility | | $173.62 | $1,177.70 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.42 / $237.36 / $759.84
| Professional | | $114.42 | $237.36 | $759.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.91 / $159.22 / $284.25
| Facility | | $123.91 | $159.22 | $284.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.31 / $257.07 / $398.94
| Professional | | $178.31 | $257.07 | $398.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.54 / $227.44 / $391.86
| Professional | | $137.54 | $227.44 | $391.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.26 / $214.32 / $6,679.00
| Facility | | $107.26 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.81 / $213.14 / $294.22
| Professional | | $175.81 | $213.14 | $294.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.91 / $290.77 / $472.32
| Professional | | $138.91 | $290.77 | $472.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.64 / $959.99 / $3,863.50
| Facility | | $884.64 | $959.99 | $3,863.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.09 / $275.86 / $817.70
| Professional | | $242.09 | $275.86 | $817.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,600.00 / $7,161.00
| Facility | | $55.00 | $1,600.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.18 / $286.86 / $1,093.83
| Professional | | $160.18 | $286.86 | $1,093.83 |
- 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
- $151.22 / $234.04 / $498.35
| Professional | | $151.22 | $234.04 | $498.35 |