- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.11 / $2,083.00 / $3,697.51
| Facility | | $126.11 | $2,083.00 | $3,697.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.19 / $149.09 / $387.84
| Professional | | $95.19 | $149.09 | $387.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.72 / $1,866.13 / $4,689.00
| Facility | | $265.72 | $1,866.13 | $4,689.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.02 / $260.00 / $867.04
| Professional | | $128.02 | $260.00 | $867.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.94 / $184.52 / $325.61
| Facility | | $141.94 | $184.52 | $325.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.95 / $278.48 / $376.25
| Professional | | $184.95 | $278.48 | $376.25 |
- 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
- $147.13 / $271.14 / $517.19
| Professional | | $147.13 | $271.14 | $517.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.89 / $214.32 / $6,679.00
| Facility | | $121.89 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.56 / $238.55 / $329.30
| Professional | | $188.56 | $238.55 | $329.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.46 / $312.17 / $501.00
| Professional | | $147.46 | $312.17 | $501.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,307.91 / $1,859.98 / $16,655.00
| Facility | | $1,307.91 | $1,859.98 | $16,655.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.62 / $280.62 / $406.73
| Professional | | $280.62 | $280.62 | $406.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,338.00 / $8,498.00
| Facility | | $55.00 | $2,338.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.71 / $310.50 / $1,222.56
| Professional | | $155.71 | $310.50 | $1,222.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.44 / $249.04 / $540.15
| Professional | | $130.44 | $249.04 | $540.15 |