- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $1,473.20 / $3,625.00
| Facility | | $52.48 | $1,473.20 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.75 / $32.64 / $94.51
| Professional | | $17.75 | $32.64 | $94.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $627.00 / $2,733.00
| Facility | | $55.00 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.50 / $57.20 / $178.72
| Professional | | $26.50 | $57.20 | $178.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.92 / $36.29 / $64.05
| Facility | | $27.92 | $36.29 | $64.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.89 / $59.41 / $86.24
| Professional | | $37.89 | $59.41 | $86.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.61 / $50.46 / $106.22
| Professional | | $27.61 | $50.46 | $106.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.90 / $168.26 / $6,679.00
| Facility | | $28.90 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.68 / $54.67 / $75.47
| Professional | | $43.68 | $54.67 | $75.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.31 / $63.43 / $107.96
| Professional | | $30.31 | $63.43 | $107.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.12 / $768.60 / $3,386.43
| Facility | | $402.12 | $768.60 | $3,386.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.50 / $79.34 / $317.36
| Professional | | $60.50 | $79.34 | $317.36 |
- 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
- $41.71 / $68.17 / $286.08
| Professional | | $41.71 | $68.17 | $286.08 |
- 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
- $34.22 / $57.20 / $117.74
| Professional | | $34.22 | $57.20 | $117.74 |