- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $2,747.00 / $4,806.64
| Facility | | $54.95 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.90 / $121.03 / $301.73
| Professional | | $57.90 | $121.03 | $301.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.47 / $679.46 / $2,713.00
| Facility | | $156.47 | $679.46 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.20 / $192.81 / $570.39
| Professional | | $76.20 | $192.81 | $570.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.40 / $107.12 / $210.12
| Facility | | $82.40 | $107.12 | $210.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.07 / $179.28 / $366.21
| Professional | | $104.07 | $179.28 | $366.21 |
- 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
- $80.02 / $178.14 / $409.10
| Professional | | $80.02 | $178.14 | $409.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.79 / $221.89 / $6,679.00
| Facility | | $71.79 | $221.89 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.03 / $212.88 / $294.39
| Professional | | $168.03 | $212.88 | $294.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.65 / $191.08 / $410.09
| Professional | | $87.65 | $191.08 | $410.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.76 / $222.07 / $235.05
| Professional | | $188.76 | $222.07 | $235.05 |
- 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
- $140.99 / $295.37 / $1,086.72
| Professional | | $140.99 | $295.37 | $1,086.72 |
- 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
- $133.85 / $217.07 / $413.65
| Professional | | $133.85 | $217.07 | $413.65 |