- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.36 / $2,747.00 / $4,806.64
| Facility | | $55.36 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.36 / $85.50 / $180.76
| Professional | | $55.36 | $85.50 | $180.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.86 / $947.00 / $2,713.00
| Facility | | $160.86 | $947.00 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.11 / $159.87 / $594.00
| Professional | | $78.11 | $159.87 | $594.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.78 / $108.91 / $192.19
| Facility | | $83.78 | $108.91 | $192.19 |
- 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
- $82.01 / $146.22 / $282.58
| Professional | | $82.01 | $146.22 | $282.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $168.26 / $6,679.00
| Facility | | $83.43 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.28 / $152.68 / $210.76
| Professional | | $121.28 | $152.68 | $210.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.29 / $189.03 / $324.81
| Professional | | $89.29 | $189.03 | $324.81 |
- 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
- $117.54 / $193.09 / $787.60
| Professional | | $117.54 | $193.09 | $787.60 |
- 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
- $104.94 / $154.85 / $306.64
| Professional | | $104.94 | $154.85 | $306.64 |