- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.04 / $1,894.00 / $17,823.00
| Facility | | $32.04 | $1,894.00 | $17,823.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.04 / $71.41 / $385.47
| Professional | | $32.04 | $71.41 | $385.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.32 / $333.06 / $2,045.47
| Professional | | $136.32 | $333.06 | $2,045.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $60.26
| Facility | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.71 / $456.09 / $1,221.01
| Professional | | $216.71 | $456.09 | $1,221.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.04 / $58.40 / $366.22
| Facility | | $32.04 | $58.40 | $366.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.86 / $180.55 / $1,789.00
| Facility | | $38.86 | $180.55 | $1,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.11 / $677.77 / $1,515.88
| Professional | | $368.11 | $677.77 | $1,515.88 |
- 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
- $32.04 / $53.66 / $361.29
| Facility | | $32.04 | $53.66 | $361.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.74 / $110.09 / $698.87
| Professional | | $59.74 | $110.09 | $698.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $410.06 / $410.06
| Facility | | $60.26 | $410.06 | $410.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.55 / $1,055.58 / $1,055.58
| Professional | | $220.55 | $1,055.58 | $1,055.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,034.00 / $1,641.00 / $2,202.90
| Facility | | $1,034.00 | $1,641.00 | $2,202.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.73 / $650.22 / $1,515.88
| Professional | | $169.73 | $650.22 | $1,515.88 |