- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.19 / $511.73 / $2,900.00
| Facility | | $92.19 | $511.73 | $2,900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.73 / $108.35 / $362.60
| Professional | | $46.73 | $108.35 | $362.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.67 / $388.80 / $2,713.00
| Facility | | $125.67 | $388.80 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.64 / $163.44 / $585.00
| Professional | | $62.64 | $163.44 | $585.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.18 / $83.43 / $163.66
| Facility | | $64.18 | $83.43 | $163.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.71 / $128.10 / $279.00
| Professional | | $59.71 | $128.10 | $279.00 |
- 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
- $81.02 / $159.66 / $330.16
| Professional | | $81.02 | $159.66 | $330.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.14 / $300.00 / $6,679.00
| Facility | | $66.14 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.91 / $162.47 / $224.28
| Professional | | $128.91 | $162.47 | $224.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.86 / $154.47 / $319.18
| Professional | | $70.86 | $154.47 | $319.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.57 / $299.75 / $571.54
| Facility | | $156.57 | $299.75 | $571.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.61 / $79.61 / $79.61
| Professional | | $79.61 | $79.61 | $79.61 |
- 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
- $142.47 / $237.76 / $1,039.46
| Professional | | $142.47 | $237.76 | $1,039.46 |
- 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
- $123.56 / $178.40 / $318.45
| Professional | | $123.56 | $178.40 | $318.45 |