- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.17 / $2,067.00 / $3,625.00
| Facility | | $54.17 | $2,067.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.79 / $56.80 / $191.74
| Professional | | $33.79 | $56.80 | $191.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.59 / $627.00 / $2,733.00
| Facility | | $118.59 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.46 / $107.65 / $386.96
| Professional | | $54.46 | $107.65 | $386.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.20 / $79.56 / $140.38
| Facility | | $61.20 | $79.56 | $140.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.02 / $72.23 / $114.13
| Professional | | $52.02 | $72.23 | $114.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.42 / $97.17 / $205.93
| Professional | | $59.42 | $97.17 | $205.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.58 / $168.26 / $6,679.00
| Facility | | $62.58 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.34 / $98.79 / $136.36
| Professional | | $79.34 | $98.79 | $136.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.36 / $137.82 / $197.78
| Professional | | $66.36 | $137.82 | $197.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $427.47 / $427.47 / $809.65
| Facility | | $427.47 | $427.47 | $809.65 |
- 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
- $71.40 / $122.40 / $520.55
| Professional | | $71.40 | $122.40 | $520.55 |
- 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
- $66.12 / $100.69 / $192.07
| Professional | | $66.12 | $100.69 | $192.07 |