- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.56 / $2,067.00 / $3,685.00
| Facility | | $72.56 | $2,067.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.78 / $88.37 / $186.42
| Professional | | $52.78 | $88.37 | $186.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.28 / $362.43 / $2,713.00
| Facility | | $159.28 | $362.43 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.47 / $148.35 / $518.64
| Professional | | $77.47 | $148.35 | $518.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.53 / $109.89 / $193.91
| Facility | | $84.53 | $109.89 | $193.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.89 / $152.88 / $221.93
| Professional | | $102.89 | $152.88 | $221.93 |
- 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
- $80.97 / $137.51 / $290.02
| Professional | | $80.97 | $137.51 | $290.02 |
- 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
- $111.32 / $140.71 / $194.23
| Professional | | $111.32 | $140.71 | $194.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.65 / $185.30 / $282.38
| Professional | | $87.65 | $185.30 | $282.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.22 / $157.86 / $165.25
| Professional | | $121.22 | $157.86 | $165.25 |
- 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
- $105.50 / $182.35 / $723.84
| Professional | | $105.50 | $182.35 | $723.84 |
- 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
- $85.04 / $134.16 / $273.52
| Professional | | $85.04 | $134.16 | $273.52 |