- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.09 / $1,319.00 / $3,363.00
| Facility | | $122.09 | $1,319.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.44 / $137.68 / $361.28
| Professional | | $65.44 | $137.68 | $361.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.88 / $1,251.81 / $7,161.00
| Facility | | $209.88 | $1,251.81 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.74 / $193.74 / $616.64
| Professional | | $95.74 | $193.74 | $616.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.80 / $133.63 / $235.82
| Facility | | $102.80 | $133.63 | $235.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.16 / $205.19 / $312.83
| Professional | | $131.16 | $205.19 | $312.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.00 / $174.41 / $345.66
| Professional | | $97.00 | $174.41 | $345.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.53 / $187.44 / $6,679.00
| Facility | | $87.53 | $187.44 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.97 / $181.15 / $251.49
| Professional | | $142.97 | $181.15 | $251.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.27 / $222.86 / $377.97
| Professional | | $105.27 | $222.86 | $377.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.49 / $743.29 / $4,649.53
| Facility | | $152.49 | $743.29 | $4,649.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.19 / $197.58 / $393.15
| Professional | | $123.19 | $197.58 | $393.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.37 / $2,078.00 / $11,500.00
| Facility | | $440.37 | $2,078.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.31 / $237.93 / $919.68
| Professional | | $135.31 | $237.93 | $919.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.91 / $177.16 / $376.11
| Professional | | $113.91 | $177.16 | $376.11 |