- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,516.00 / $5,845.00 / $10,686.00
| Facility | | $1,516.00 | $5,845.00 | $10,686.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.60 / $13.60 / $49.09
| Professional | | $13.60 | $13.60 | $49.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.00 / $7,264.00 / $12,274.00
| Facility | | $4,100.00 | $7,264.00 | $12,274.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.86 / $58.15 / $182.85
| Professional | | $45.86 | $58.15 | $182.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.23 / $79.23 / $16,534.50
| Facility | | $79.23 | $79.23 | $16,534.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.23 / $79.23 / $79.23
| Professional | | $79.23 | $79.23 | $79.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.01 / $70.01 / $7,227.90
| Facility | | $70.01 | $70.01 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.41 / $631.41 / $631.41
| Professional | | $631.41 | $631.41 | $631.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.16 / $124.58 / $199.52
| Professional | | $59.16 | $124.58 | $199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.01 / $555.00 / $7,227.90
| Facility | | $70.01 | $555.00 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.41 / $631.41 / $631.41
| Professional | | $631.41 | $631.41 | $631.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,337.00 / $6,450.00 / $12,742.00
| Facility | | $2,337.00 | $6,450.00 | $12,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.63 / $71.33 / $166.28
| Professional | | $43.63 | $71.33 | $166.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.16 / $59.16 / $317.81
| Facility | | $59.16 | $59.16 | $317.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.16 / $82.94 / $176.28
| Professional | | $59.16 | $82.94 | $176.28 |