- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.29 / $1,473.20 / $3,363.00
| Facility | | $168.29 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.99 / $159.63 / $316.55
| Professional | | $106.99 | $159.63 | $316.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.24 / $1,177.70 / $3,472.00
| Facility | | $187.24 | $1,177.70 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.12 / $255.00 / $819.60
| Professional | | $122.12 | $255.00 | $819.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.22 / $172.47 / $307.89
| Facility | | $134.22 | $172.47 | $307.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.26 / $292.02 / $746.12
| Professional | | $171.26 | $292.02 | $746.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.86 / $239.92 / $417.63
| Professional | | $146.86 | $239.92 | $417.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.24 / $214.32 / $6,679.00
| Facility | | $116.24 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.72 / $223.76 / $308.72
| Professional | | $184.72 | $223.76 | $308.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.22 / $316.88 / $498.84
| Professional | | $150.22 | $316.88 | $498.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,181.74 / $1,181.74 / $1,181.74
| Facility | | $1,181.74 | $1,181.74 | $1,181.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.72 / $165.72 / $187.52
| Professional | | $165.72 | $165.72 | $187.52 |
- 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
- $168.60 / $301.44 / $1,146.48
| Professional | | $168.60 | $301.44 | $1,146.48 |
- 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
- $164.44 / $243.53 / $453.93
| Professional | | $164.44 | $243.53 | $453.93 |