- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.35 / $1,925.24 / $7,197.00
| Facility | | $110.35 | $1,925.24 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.86 / $93.65 / $188.46
| Professional | | $57.86 | $93.65 | $188.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.85 / $183.00 / $225.22
| Professional | | $119.85 | $183.00 | $225.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.77 / $114.69 / $192.68
| Professional | | $77.77 | $114.69 | $192.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.41 / $184.38 / $191.04
| Professional | | $143.41 | $184.38 | $191.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.74 / $1,733.03 / $2,167.42
| Facility | | $539.74 | $1,733.03 | $2,167.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,266.00 / $8,017.00
| Facility | | $540.00 | $2,266.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.47 / $110.35 / $508.21
| Professional | | $66.47 | $110.35 | $508.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.10 / $135.10 / $135.10
| Professional | | $135.10 | $135.10 | $135.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.77 / $164.77 / $164.77
| Facility | | $164.77 | $164.77 | $164.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.30 / $118.73 / $209.89
| Professional | | $84.30 | $118.73 | $209.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.39 / $94.51 / $117.59
| Facility | | $71.39 | $94.51 | $117.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.76 / $98.85 / $124.25
| Professional | | $90.76 | $98.85 | $124.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $577.00 / $3,742.00
| Facility | | $144.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.22 / $127.40 / $231.75
| Professional | | $91.22 | $127.40 | $231.75 |