- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.10 / $1,803.00 / $3,363.00
| Facility | | $139.10 | $1,803.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.49 / $121.80 / $526.22
| Professional | | $32.49 | $121.80 | $526.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.86 / $502.00 / $2,733.00
| Facility | | $92.86 | $502.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.29 / $562.75 / $1,436.23
| Professional | | $46.29 | $562.75 | $1,436.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.13 / $61.27 / $120.18
| Facility | | $47.13 | $61.27 | $120.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.07 / $94.07 / $717.96
| Professional | | $94.07 | $94.07 | $717.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.17 / $437.70 / $1,115.86
| Professional | | $74.17 | $437.70 | $1,115.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.39 / $85.94 / $8,090.00
| Facility | | $48.39 | $85.94 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.50 / $426.32 / $760.25
| Professional | | $336.50 | $426.32 | $760.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.06 / $168.62 / $780.26
| Professional | | $52.06 | $168.62 | $780.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.92 / $302.92 / $302.92
| Facility | | $302.92 | $302.92 | $302.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.12 / $827.90 / $2,060.00
| Professional | | $459.12 | $827.90 | $2,060.00 |
- 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
- $352.26 / $635.09 / $1,167.99
| Professional | | $352.26 | $635.09 | $1,167.99 |