- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.03 / $3,102.00 / $10,836.00
| Facility | | $440.03 | $3,102.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.19 / $300.02 / $496.13
| Professional | | $199.19 | $300.02 | $496.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.16 / $420.21 / $1,022.81
| Facility | | $222.16 | $420.21 | $1,022.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.84 / $174.84 / $311.05
| Facility | | $174.84 | $174.84 | $311.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.76 / $272.76 / $281.68
| Facility | | $272.76 | $272.76 | $281.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.38 / $312.43 / $524.00
| Professional | | $205.38 | $312.43 | $524.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $1,372.68
| Facility | | $55.00 | $55.00 | $1,372.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,452.00 / $2,526.44 / $3,340.29
| Professional | | $1,452.00 | $2,526.44 | $3,340.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.72 / $320.97 / $539.76
| Facility | | $193.72 | $320.97 | $539.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.14 / $329.39 / $497.10
| Professional | | $213.14 | $329.39 | $497.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.44 / $279.88 / $367.56
| Professional | | $194.44 | $279.88 | $367.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.72 / $320.97 / $551.49
| Facility | | $193.72 | $320.97 | $551.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.47 / $331.44 / $546.36
| Professional | | $210.47 | $331.44 | $546.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $3,264.00 / $7,600.00
| Facility | | $1,120.00 | $3,264.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.90 / $309.91 / $473.37
| Professional | | $227.90 | $309.91 | $473.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.56 / $279.88 / $396.97
| Professional | | $249.56 | $279.88 | $396.97 |