- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.71 / $2,070.00 / $7,629.00
| Facility | | $84.71 | $2,070.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.83 / $83.80 / $155.88
| Professional | | $48.83 | $83.80 | $155.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.70 / $96.20 / $96.20
| Professional | | $92.70 | $96.20 | $96.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.66 / $92.00 / $166.53
| Professional | | $53.66 | $92.00 | $166.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.80 / $142.44 / $146.91
| Professional | | $110.80 | $142.44 | $146.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,326.00 / $8,017.00
| Facility | | $540.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.10 / $93.02 / $291.38
| Professional | | $53.10 | $93.02 | $291.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.40 / $120.40 / $126.50
| Professional | | $120.40 | $120.40 | $126.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.50 / $94.50 / $94.50
| Facility | | $94.50 | $94.50 | $94.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.67 / $92.00 / $179.88
| Professional | | $54.67 | $92.00 | $179.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.83 / $78.45 / $98.99
| Facility | | $54.83 | $78.45 | $98.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.83 / $89.32 / $97.52
| Professional | | $54.83 | $89.32 | $97.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $577.00 / $3,742.00
| Facility | | $144.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.28 / $102.59 / $179.71
| Professional | | $80.28 | $102.59 | $179.71 |