- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.01 / $2,747.00 / $4,806.64
| Facility | | $49.01 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.28 / $111.59 / $286.86
| Professional | | $52.28 | $111.59 | $286.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.03 / $355.54 / $2,713.00
| Facility | | $138.03 | $355.54 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.31 / $174.52 / $512.88
| Professional | | $66.31 | $174.52 | $512.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.25 / $91.33 / $179.14
| Facility | | $70.25 | $91.33 | $179.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.33 / $156.06 / $330.10
| Professional | | $95.33 | $156.06 | $330.10 |
- 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
- $69.63 / $160.58 / $373.79
| Professional | | $69.63 | $160.58 | $373.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.08 / $205.00 / $6,679.00
| Facility | | $65.08 | $205.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.71 / $192.21 / $265.37
| Professional | | $151.71 | $192.21 | $265.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.37 / $167.12 / $371.02
| Professional | | $75.37 | $167.12 | $371.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.54 / $204.77 / $242.17
| Professional | | $167.54 | $204.77 | $242.17 |
- 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
- $124.62 / $274.02 / $984.08
| Professional | | $124.62 | $274.02 | $984.08 |
- 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
- $106.65 / $193.60 / $370.17
| Professional | | $106.65 | $193.60 | $370.17 |