- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.30 / $2,671.00 / $4,806.64
| Facility | | $66.30 | $2,671.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.30 / $95.08 / $276.18
| Professional | | $66.30 | $95.08 | $276.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.44 / $197.23 / $837.36
| Professional | | $106.44 | $197.23 | $837.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.17 / $78.22 / $153.43
| Facility | | $60.17 | $78.22 | $153.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.73 / $137.60 / $312.43
| Professional | | $60.73 | $137.60 | $312.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.15 / $168.26 / $6,679.00
| Facility | | $61.15 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.59 / $164.19 / $227.39
| Professional | | $129.59 | $164.19 | $227.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.90 / $142.54 / $317.72
| Professional | | $63.90 | $142.54 | $317.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.83 / $188.06 / $203.62
| Professional | | $165.83 | $188.06 | $203.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.18 / $207.66 / $837.36
| Professional | | $107.18 | $207.66 | $837.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $3,445.00
| Facility | | $627.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.08 / $154.38 / $321.00
| Professional | | $87.08 | $154.38 | $321.00 |