- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.55 / $1,894.00 / $14,482.00
| Facility | | $41.55 | $1,894.00 | $14,482.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $45.08 / $70.54
| Professional | | $8.32 | $45.08 | $70.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,139.00 / $2,479.00 / $4,441.52
| Facility | | $1,139.00 | $2,479.00 | $4,441.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.77 / $81.23 / $226.48
| Professional | | $18.77 | $81.23 | $226.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.50 / $90.56 / $146.07
| Facility | | $77.50 | $90.56 | $146.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.21 / $34.19 / $40.31
| Professional | | $33.21 | $34.19 | $40.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.53 / $61.83 / $162.84
| Facility | | $38.53 | $61.83 | $162.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.61 / $1,198.00 / $2,043.20
| Facility | | $48.61 | $1,198.00 | $2,043.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.91 / $61.28 / $165.52
| Professional | | $21.91 | $61.28 | $165.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $58.40 / $70.00
| Professional | | $50.00 | $58.40 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.53 / $61.83 / $162.84
| Facility | | $38.53 | $61.83 | $162.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.90 / $209.82 / $292.60
| Professional | | $34.90 | $209.82 | $292.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.67 / $402.67 / $402.67
| Facility | | $402.67 | $402.67 | $402.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.80 / $547.67 / $547.67
| Professional | | $375.80 | $547.67 | $547.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.14 / $86.39 / $86.39
| Professional | | $58.14 | $86.39 | $86.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,034.00 / $1,423.00 / $2,202.90
| Facility | | $1,034.00 | $1,423.00 | $2,202.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.46 / $66.67 / $116.21
| Professional | | $22.46 | $66.67 | $116.21 |