- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.14 / $2,079.00 / $3,625.00
| Facility | | $331.14 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.17 / $322.13 / $542.34
| Professional | | $168.17 | $322.13 | $542.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.98 / $1,339.09 / $4,393.72
| Facility | | $370.98 | $1,339.09 | $4,393.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.09 / $445.66 / $1,208.08
| Professional | | $183.09 | $445.66 | $1,208.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.36 / $253.97 / $498.17
| Facility | | $195.36 | $253.97 | $498.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.35 / $448.35 / $1,316.29
| Professional | | $448.35 | $448.35 | $1,316.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.33 / $304.33 / $304.33
| Facility | | $304.33 | $304.33 | $304.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.47 / $439.96 / $894.27
| Professional | | $237.47 | $439.96 | $894.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.26 / $267.17 / $6,679.00
| Facility | | $168.26 | $267.17 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.45 / $459.21 / $637.16
| Professional | | $362.45 | $459.21 | $637.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.75 / $447.63 / $1,039.40
| Professional | | $202.75 | $447.63 | $1,039.40 |
- 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
- $354.31 / $610.04 / $3,192.34
| Professional | | $354.31 | $610.04 | $3,192.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.00 / $2,078.00 / $5,683.00
| Facility | | $700.00 | $2,078.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.46 / $480.54 / $1,004.82
| Professional | | $329.46 | $480.54 | $1,004.82 |