- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.50 / $988.00 / $3,047.03
| Facility | | $68.50 | $988.00 | $3,047.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.20 / $62.04 / $253.00
| Professional | | $41.20 | $62.04 | $253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.63 / $818.35 / $2,796.00
| Facility | | $115.63 | $818.35 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.41 / $110.09 / $362.00
| Professional | | $46.41 | $110.09 | $362.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.59 / $73.16 / $129.11
| Facility | | $58.59 | $73.16 | $129.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.28 / $106.90 / $152.02
| Professional | | $77.28 | $106.90 | $152.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.00 / $117.67 / $225.20
| Professional | | $82.00 | $117.67 | $225.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.73 / $168.26 / $6,679.00
| Facility | | $57.73 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.26 / $86.00 / $154.22
| Professional | | $68.26 | $86.00 | $154.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.14 / $126.85 / $165.07
| Professional | | $62.14 | $126.85 | $165.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.25 / $677.27 / $784.71
| Facility | | $76.25 | $677.27 | $784.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.95 / $97.42 / $153.84
| Professional | | $75.95 | $97.42 | $153.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.40 / $1,790.00 / $3,445.00
| Facility | | $240.40 | $1,790.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.81 / $130.06 / $438.32
| Professional | | $71.81 | $130.06 | $438.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.08 / $91.52 / $191.43
| Professional | | $62.08 | $91.52 | $191.43 |