- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.98 / $2,747.00 / $8,113.00
| Facility | | $62.98 | $2,747.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.18 / $115.37 / $190.73
| Professional | | $62.18 | $115.37 | $190.73 |
- 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
- $140.32 / $145.62 / $145.62
| Professional | | $140.32 | $145.62 | $145.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.41 / $128.44 / $230.96
| Professional | | $67.41 | $128.44 | $230.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.20 / $167.44 / $221.41
| Professional | | $43.20 | $167.44 | $221.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.81 / $139.50 / $145.08
| Professional | | $80.81 | $139.50 | $145.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $4,264.00 / $8,247.00
| Facility | | $540.00 | $4,264.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.98 / $123.91 / $262.92
| Professional | | $62.98 | $123.91 | $262.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.20 / $125.60 / $197.03
| Professional | | $65.20 | $125.60 | $197.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.50 / $118.50 / $118.50
| Facility | | $118.50 | $118.50 | $118.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.47 / $131.05 / $244.37
| Professional | | $68.47 | $131.05 | $244.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.65 / $86.53 / $142.63
| Facility | | $68.65 | $86.53 | $142.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.65 / $118.94 / $152.66
| Professional | | $68.65 | $118.94 | $152.66 |
- 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
- $110.24 / $153.68 / $267.23
| Professional | | $110.24 | $153.68 | $267.23 |