- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.84 / $2,747.00 / $4,806.64
| Facility | | $57.84 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.65 / $124.49 / $318.30
| Professional | | $60.65 | $124.49 | $318.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.91 / $679.46 / $2,713.00
| Facility | | $165.91 | $679.46 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.54 / $199.06 / $583.78
| Professional | | $79.54 | $199.06 | $583.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.94 / $111.72 / $219.15
| Facility | | $85.94 | $111.72 | $219.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.42 / $187.87 / $374.99
| Professional | | $115.42 | $187.87 | $374.99 |
- 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
- $83.52 / $182.41 / $419.87
| Professional | | $83.52 | $182.41 | $419.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.87 / $220.00 / $6,679.00
| Facility | | $74.87 | $220.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.11 / $218.06 / $301.45
| Professional | | $172.11 | $218.06 | $301.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.34 / $199.12 / $422.71
| Professional | | $91.34 | $199.12 | $422.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.07 / $224.24 / $267.01
| Professional | | $104.07 | $224.24 | $267.01 |
- 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
- $136.78 / $303.94 / $1,113.92
| Professional | | $136.78 | $303.94 | $1,113.92 |
- 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
- $121.77 / $222.83 / $427.10
| Professional | | $121.77 | $222.83 | $427.10 |