- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.93 / $1,886.00 / $3,625.00
| Facility | | $50.93 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.77 / $50.93 / $156.43
| Professional | | $22.77 | $50.93 | $156.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.88 / $355.54 / $2,713.00
| Facility | | $61.88 | $355.54 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.85 / $104.12 / $373.00
| Professional | | $30.85 | $104.12 | $373.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.67 / $41.17 / $80.76
| Facility | | $31.67 | $41.17 | $80.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $42.53 / $146.33
| Professional | | $26.92 | $42.53 | $146.33 |
- 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
- $31.96 / $97.06 / $242.39
| Professional | | $31.96 | $97.06 | $242.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.07 / $151.52 / $6,679.00
| Facility | | $33.07 | $151.52 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.47 / $126.03 / $174.84
| Professional | | $99.47 | $126.03 | $174.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.40 / $98.50 / $253.85
| Professional | | $34.40 | $98.50 | $253.85 |
- 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
- $74.56 / $144.31 / $643.20
| Professional | | $74.56 | $144.31 | $643.20 |
- 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
- $62.37 / $114.41 / $239.48
| Professional | | $62.37 | $114.41 | $239.48 |