- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.81 / $2,079.00 / $3,625.00
| Facility | | $60.81 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.27 / $67.55 / $138.96
| Professional | | $39.27 | $67.55 | $138.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.13 / $627.00 / $2,733.00
| Facility | | $111.13 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.57 / $113.76 / $361.60
| Professional | | $53.57 | $113.76 | $361.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.21 / $74.37 / $131.24
| Facility | | $57.21 | $74.37 | $131.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.63 / $122.68 / $201.71
| Professional | | $77.63 | $122.68 | $201.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.55 / $101.25 / $215.37
| Professional | | $55.55 | $101.25 | $215.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.16 / $168.26 / $6,679.00
| Facility | | $58.16 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.65 / $112.90 / $155.85
| Professional | | $89.65 | $112.90 | $155.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.62 / $126.85 / $219.55
| Professional | | $60.62 | $126.85 | $219.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.89 / $257.89 / $754.56
| Professional | | $257.89 | $257.89 | $754.56 |
- 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
- $85.27 / $148.86 / $1,070.26
| Professional | | $85.27 | $148.86 | $1,070.26 |
- 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
- $75.09 / $108.78 / $223.10
| Professional | | $75.09 | $108.78 | $223.10 |