- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.02 / $2,159.00 / $6,962.00
| Facility | | $133.02 | $2,159.00 | $6,962.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.55 / $159.55 / $440.20
| Professional | | $88.55 | $159.55 | $440.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,691.00 / $3,382.00 / $4,707.00
| Facility | | $1,691.00 | $3,382.00 | $4,707.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.70 / $211.06 / $427.48
| Professional | | $100.70 | $211.06 | $427.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.91 / $146.91 / $4,050.00
| Facility | | $146.91 | $146.91 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.91 / $146.91 / $346.49
| Professional | | $146.91 | $146.91 | $346.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.87 / $175.87 / $14,648.00
| Facility | | $175.87 | $175.87 | $14,648.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.25 / $216.74 / $534.09
| Professional | | $96.25 | $216.74 | $534.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $137.94 / $332.00
| Facility | | $75.00 | $137.94 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.00 / $94.82 / $493.64
| Professional | | $12.00 | $94.82 | $493.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.06 / $236.22 / $460.91
| Professional | | $139.06 | $236.22 | $460.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $733.44 / $915.05 / $1,386.45
| Facility | | $733.44 | $915.05 | $1,386.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.87 / $555.00 / $74,999.25
| Facility | | $175.87 | $555.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.33 / $256.18 / $547.40
| Professional | | $107.33 | $256.18 | $547.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,336.00 / $3,496.00 / $5,963.00
| Facility | | $1,336.00 | $3,496.00 | $5,963.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.52 / $236.90 / $537.24
| Professional | | $140.52 | $236.90 | $537.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.35 / $113.35 / $325.72
| Facility | | $113.35 | $113.35 | $325.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.06 / $267.79 / $526.59
| Professional | | $139.06 | $267.79 | $526.59 |