- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.63 / $2,747.00 / $4,806.64
| Facility | | $51.63 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.63 / $79.98 / $120.69
| Professional | | $51.63 | $79.98 | $120.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.50 / $512.58 / $2,713.00
| Facility | | $116.50 | $512.58 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.63 / $162.19 / $744.40
| Professional | | $77.63 | $162.19 | $744.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.05 / $108.00 / $192.81
| Facility | | $84.05 | $108.00 | $192.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.06 / $147.82 / $280.69
| Professional | | $83.06 | $147.82 | $280.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.04 / $185.50 / $6,679.00
| Facility | | $72.04 | $185.50 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.04 / $146.44 / $202.33
| Professional | | $120.04 | $146.44 | $202.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.03 / $193.33 / $293.08
| Professional | | $92.03 | $193.33 | $293.08 |
- 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
- $100.69 / $199.48 / $744.40
| Professional | | $100.69 | $199.48 | $744.40 |
- 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
- $96.61 / $144.90 / $307.19
| Professional | | $96.61 | $144.90 | $307.19 |