- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.48 / $2,067.00 / $3,625.00
| Facility | | $58.48 | $2,067.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.46 / $58.48 / $91.38
| Professional | | $25.46 | $58.48 | $91.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.47 / $818.35 / $2,796.00
| Facility | | $71.47 | $818.35 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.77 / $92.80 / $250.50
| Professional | | $32.77 | $92.80 | $250.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.47 / $46.59 / $89.33
| Facility | | $36.47 | $46.59 | $89.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.54 / $85.57 / $177.70
| Professional | | $47.54 | $85.57 | $177.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.40 / $82.24 / $182.45
| Professional | | $34.40 | $82.24 | $182.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.94 / $168.26 / $6,679.00
| Facility | | $35.94 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.22 / $99.11 / $137.30
| Professional | | $78.22 | $99.11 | $137.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.27 / $86.02 / $189.85
| Professional | | $37.27 | $86.02 | $189.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.69 / $98.69 / $98.69
| Professional | | $98.69 | $98.69 | $98.69 |
- 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
- $80.04 / $119.83 / $505.12
| Professional | | $80.04 | $119.83 | $505.12 |
- 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
- $67.87 / $105.23 / $209.18
| Professional | | $67.87 | $105.23 | $209.18 |