- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.46 / $2,124.00 / $6,762.00
| Facility | | $241.46 | $2,124.00 | $6,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.28 / $148.97 / $227.72
| Professional | | $42.28 | $148.97 | $227.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,845.00 / $3,017.00 / $4,353.00
| Facility | | $1,845.00 | $3,017.00 | $4,353.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.25 / $147.00 / $297.32
| Professional | | $45.25 | $147.00 | $297.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.96 / $41.96 / $41.96
| Facility | | $41.96 | $41.96 | $41.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.98 / $195.72 / $351.14
| Professional | | $56.98 | $195.72 | $351.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $337.45
| Facility | | $55.00 | $55.00 | $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
- $47.21 / $140.56 / $298.39
| Facility | | $47.21 | $140.56 | $298.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.40 / $195.70 / $311.33
| Professional | | $61.40 | $195.70 | $311.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.46 / $237.80 / $269.89
| Professional | | $58.46 | $237.80 | $269.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.24 / $147.05 / $351.82
| Facility | | $47.24 | $147.05 | $351.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.95 / $200.02 / $360.54
| Professional | | $57.95 | $200.02 | $360.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $1,058.00 / $2,668.00
| Facility | | $161.00 | $1,058.00 | $2,668.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.69 / $223.58 / $359.74
| Professional | | $159.69 | $223.58 | $359.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.84 / $169.86 / $241.46
| Professional | | $151.84 | $169.86 | $241.46 |