- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.56 / $384.42 / $3,853.00
| Facility | | $116.56 | $384.42 | $3,853.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.27 / $103.30 / $322.58
| Professional | | $48.27 | $103.30 | $322.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $950.40 / $1,359.00 / $5,044.89
| Facility | | $950.40 | $1,359.00 | $5,044.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.32 / $182.43 / $190.78
| Professional | | $111.32 | $182.43 | $190.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.00 / $328.00 / $328.00
| Facility | | $328.00 | $328.00 | $328.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.45 / $98.45 / $176.14
| Professional | | $51.45 | $98.45 | $176.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.16 / $171.22 / $176.02
| Professional | | $133.16 | $171.22 | $176.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.60 / $476.88 / $1,032.23
| Facility | | $234.60 | $476.88 | $1,032.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.20 / $110.20 / $110.20
| Professional | | $110.20 | $110.20 | $110.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.04 / $756.13 / $5,342.00
| Facility | | $112.04 | $756.13 | $5,342.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.86 / $115.52 / $336.00
| Professional | | $50.86 | $115.52 | $336.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.50 / $83.50 / $176.78
| Professional | | $83.50 | $83.50 | $176.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.89 / $91.89 / $328.00
| Facility | | $91.89 | $91.89 | $328.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.84 / $100.47 / $187.93
| Professional | | $51.84 | $100.47 | $187.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.56 / $60.20 / $111.37
| Facility | | $52.56 | $60.20 | $111.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.56 / $90.48 / $119.48
| Professional | | $52.56 | $90.48 | $119.48 |
- 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
- $81.41 / $114.07 / $192.19
| Professional | | $81.41 | $114.07 | $192.19 |