- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.96 / $3,616.11 / $8,579.29
| Facility | | $969.96 | $3,616.11 | $8,579.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.02 / $878.27 / $1,046.78
| Professional | | $66.02 | $878.27 | $1,046.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.00 / $486.00 / $876.00
| Facility | | $203.00 | $486.00 | $876.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.37 / $195.40 / $953.29
| Professional | | $14.37 | $195.40 | $953.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.00 / $40.00 / $40.00
| Professional | | $40.00 | $40.00 | $40.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.93 / $140.93 / $140.93
| Facility | | $140.93 | $140.93 | $140.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.60 / $44.24 / $71.14
| Professional | | $33.60 | $44.24 | $71.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.93 / $638.07 / $801.00
| Professional | | $393.93 | $638.07 | $801.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.81 / $995.80 / $995.80
| Facility | | $84.81 | $995.80 | $995.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,657.26 / $3,657.26 / $3,657.26
| Professional | | $3,657.26 | $3,657.26 | $3,657.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.00 / $85.00 / $85.00
| Professional | | $60.00 | $85.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.09 / $74.73 / $1,092.48
| Facility | | $53.09 | $74.73 | $1,092.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.60 / $44.27 / $74.70
| Professional | | $33.60 | $44.27 | $74.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.71 / $144.71 / $144.71
| Facility | | $144.71 | $144.71 | $144.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $769.91 / $1,105.20 / $2,550.56
| Professional | | $769.91 | $1,105.20 | $2,550.56 |