- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.17 / $2,747.00 / $4,806.64
| Facility | | $54.17 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.17 / $115.37 / $235.27
| Professional | | $54.17 | $115.37 | $235.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.04 / $679.46 / $2,713.00
| Facility | | $153.04 | $679.46 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.64 / $189.25 / $540.60
| Professional | | $73.64 | $189.25 | $540.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.06 / $101.48 / $199.05
| Facility | | $78.06 | $101.48 | $199.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.93 / $173.19 / $345.69
| Professional | | $105.93 | $173.19 | $345.69 |
- 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
- $77.31 / $169.62 / $391.21
| Professional | | $77.31 | $169.62 | $391.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.34 / $253.86 / $6,679.00
| Facility | | $80.34 | $253.86 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.54 / $201.32 / $277.89
| Professional | | $159.54 | $201.32 | $277.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.38 / $183.95 / $390.13
| Professional | | $84.38 | $183.95 | $390.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.09 / $195.09 / $205.03
| Professional | | $195.09 | $195.09 | $205.03 |
- 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
- $141.44 / $285.33 / $1,040.72
| Professional | | $141.44 | $285.33 | $1,040.72 |
- 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
- $110.98 / $210.43 / $390.13
| Professional | | $110.98 | $210.43 | $390.13 |