- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.96 / $2,663.12 / $3,693.00
| Facility | | $25.96 | $2,663.12 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.69 / $77.44 / $257.37
| Professional | | $26.69 | $77.44 | $257.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.22 / $355.54 / $2,713.00
| Facility | | $75.22 | $355.54 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.44 / $118.80 / $368.16
| Professional | | $36.44 | $118.80 | $368.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.95 / $50.64 / $99.32
| Facility | | $38.95 | $50.64 | $99.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.31 / $112.88 / $251.99
| Professional | | $52.31 | $112.88 | $251.99 |
- 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
- $37.82 / $110.66 / $275.83
| Professional | | $37.82 | $110.66 | $275.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.61 / $90.18 / $6,679.00
| Facility | | $39.61 | $90.18 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.36 / $139.82 / $194.69
| Professional | | $110.36 | $139.82 | $194.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.37 / $109.96 / $269.33
| Professional | | $41.37 | $109.96 | $269.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.40 / $221.87 / $3,122.51
| Facility | | $68.40 | $221.87 | $3,122.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.51 / $134.51 / $158.74
| Professional | | $62.51 | $134.51 | $158.74 |
- 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
- $76.45 / $186.45 / $709.12
| Professional | | $76.45 | $186.45 | $709.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.76 / $53.85 / $110.01
| Professional | | $31.76 | $53.85 | $110.01 |
- 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
- $72.62 / $141.97 / $293.47
| Professional | | $72.62 | $141.97 | $293.47 |