- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.41 / $4,848.00 / $16,713.00
| Facility | | $295.41 | $4,848.00 | $16,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.32 / $186.27 / $331.63
| Professional | | $44.32 | $186.27 | $331.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,723.00 / $4,465.00 / $9,381.00
| Facility | | $1,723.00 | $4,465.00 | $9,381.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.05 / $251.75 / $551.89
| Professional | | $59.05 | $251.75 | $551.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.09 / $100.00 / $27,955.87
| Facility | | $77.09 | $100.00 | $27,955.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.54 / $145.69 / $376.22
| Professional | | $49.54 | $145.69 | $376.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.68 / $209.43 / $572.96
| Professional | | $53.68 | $209.43 | $572.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.16 / $186.15 / $279.23
| Professional | | $53.16 | $186.15 | $279.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.72 / $171.54 / $349.98
| Professional | | $48.72 | $171.54 | $349.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $337.45 / $337.45
| Facility | | $55.00 | $337.45 | $337.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $685.21 / $1,321.12 / $1,543.20
| Professional | | $685.21 | $1,321.12 | $1,543.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.65 / $152.74 / $306.00
| Facility | | $53.65 | $152.74 | $306.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.16 / $214.62 / $534.02
| Professional | | $56.16 | $214.62 | $534.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.43 / $167.43 / $697.58
| Professional | | $167.43 | $167.43 | $697.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.86 / $192.94 / $279.23
| Professional | | $48.86 | $192.94 | $279.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.00 / $1,533.00 / $7,317.00
| Facility | | $559.00 | $1,533.00 | $7,317.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.20 / $241.59 / $720.60
| Professional | | $165.20 | $241.59 | $720.60 |