- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.31 / $2,079.00 / $3,625.00
| Facility | | $78.31 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.78 / $78.31 / $186.90
| Professional | | $60.78 | $78.31 | $186.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.13 / $536.38 / $2,713.00
| Facility | | $107.13 | $536.38 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.76 / $144.06 / $474.64
| Professional | | $69.76 | $144.06 | $474.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.08 / $99.05 / $176.82
| Facility | | $77.08 | $99.05 | $176.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.45 / $151.86 / $229.60
| Professional | | $105.45 | $151.86 | $229.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.64 / $132.97 / $243.41
| Professional | | $82.64 | $132.97 | $243.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.64 / $140.54 / $8,090.00
| Facility | | $66.64 | $140.54 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.35 / $122.76 / $169.33
| Professional | | $101.35 | $122.76 | $169.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.55 / $177.56 / $252.04
| Professional | | $83.55 | $177.56 | $252.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.63 / $435.63 / $435.63
| Facility | | $435.63 | $435.63 | $435.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.00 / $153.61 / $157.40
| Professional | | $110.00 | $153.61 | $157.40 |
- 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
- $92.92 / $166.41 / $634.48
| Professional | | $92.92 | $166.41 | $634.48 |
- 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
- $90.71 / $134.41 / $252.04
| Professional | | $90.71 | $134.41 | $252.04 |