- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.54 / $2,070.00 / $7,629.00
| Facility | | $128.54 | $2,070.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.58 / $120.48 / $228.24
| Professional | | $73.58 | $120.48 | $228.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.81 / $170.66 / $221.86
| Professional | | $137.81 | $170.66 | $221.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.67 / $130.01 / $230.80
| Professional | | $79.67 | $130.01 | $230.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.89 / $213.29 / $219.67
| Professional | | $165.89 | $213.29 | $219.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.13 / $135.36 / $162.44
| Professional | | $83.13 | $135.36 | $162.44 |
- 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
- $76.93 / $126.23 / $262.97
| Professional | | $76.93 | $126.23 | $262.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.33 / $119.60 / $194.13
| Professional | | $82.33 | $119.60 | $194.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.53 / $147.53 / $147.53
| Facility | | $147.53 | $147.53 | $147.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.49 / $132.28 / $246.52
| Professional | | $83.49 | $132.28 | $246.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.17 / $83.60 / $135.44
| Facility | | $83.17 | $83.60 | $135.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.17 / $122.78 / $145.49
| Professional | | $83.17 | $122.78 | $145.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.93 / $146.77 / $253.38
| Professional | | $116.93 | $146.77 | $253.38 |