- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.11 / $1,418.00 / $3,363.00
| Facility | | $116.11 | $1,418.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.20 / $108.73 / $257.33
| Professional | | $67.20 | $108.73 | $257.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.39 / $941.10 / $4,142.00
| Facility | | $198.39 | $941.10 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.97 / $184.20 / $589.84
| Professional | | $87.97 | $184.20 | $589.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.87 / $122.03 / $215.34
| Facility | | $93.87 | $122.03 | $215.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.62 / $204.23 / $299.26
| Professional | | $143.62 | $204.23 | $299.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.57 / $192.76 / $406.31
| Professional | | $103.57 | $192.76 | $406.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $171.16 / $6,679.00
| Facility | | $83.43 | $171.16 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.72 / $174.28 / $240.57
| Professional | | $138.72 | $174.28 | $240.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.35 / $208.99 / $340.80
| Professional | | $100.35 | $208.99 | $340.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.87 / $543.03 / $849.47
| Facility | | $219.87 | $543.03 | $849.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.12 / $199.12 / $204.17
| Professional | | $199.12 | $199.12 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $399.57 / $1,818.00 / $12,000.00
| Facility | | $399.57 | $1,818.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.62 / $250.41 / $904.80
| Professional | | $128.62 | $250.41 | $904.80 |
- 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
- $113.46 / $184.20 / $340.22
| Professional | | $113.46 | $184.20 | $340.22 |