- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.53 / $2,747.00 / $8,104.00
| Facility | | $132.53 | $2,747.00 | $8,104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.74 / $122.21 / $248.96
| Professional | | $61.74 | $122.21 | $248.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.79 / $152.33 / $252.17
| Professional | | $146.79 | $152.33 | $252.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.09 / $129.34 / $237.05
| Professional | | $65.09 | $129.34 | $237.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.21 / $227.84 / $234.84
| Professional | | $177.21 | $227.84 | $234.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.46 / $145.24 / $149.60
| Professional | | $123.46 | $145.24 | $149.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $3,964.00 / $8,247.00
| Facility | | $540.00 | $3,964.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.04 / $130.66 / $260.20
| Professional | | $63.04 | $130.66 | $260.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.11 / $120.20 / $207.06
| Professional | | $67.11 | $120.20 | $207.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.18 / $121.18 / $121.18
| Facility | | $121.18 | $121.18 | $121.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.14 / $130.96 / $241.07
| Professional | | $68.14 | $130.96 | $241.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.11 / $72.31 / $147.51
| Facility | | $69.11 | $72.31 | $147.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.11 / $110.80 / $158.69
| Professional | | $69.11 | $110.80 | $158.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.33 / $158.96 / $267.64
| Professional | | $113.33 | $158.96 | $267.64 |