- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.34 / $2,747.00 / $8,113.00
| Facility | | $90.34 | $2,747.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.25 / $86.12 / $110.17
| Professional | | $62.25 | $86.12 | $110.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.70 / $105.53 / $118.82
| Professional | | $101.70 | $105.53 | $118.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.61 / $118.61 / $118.61
| Facility | | $118.61 | $118.61 | $118.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.26 / $100.61 / $175.76
| Professional | | $66.26 | $100.61 | $175.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.32 / $164.85 / $211.28
| Professional | | $122.32 | $164.85 | $211.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,427.00
| Facility | | $657.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.06 / $96.00 / $364.19
| Professional | | $64.06 | $96.00 | $364.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.60 / $101.60 / $250.20
| Professional | | $101.60 | $101.60 | $250.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.61 / $118.61 / $118.61
| Facility | | $118.61 | $118.61 | $118.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.63 / $101.66 / $181.57
| Professional | | $66.63 | $101.66 | $181.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.02 / $67.30 / $96.71
| Facility | | $56.02 | $67.30 | $96.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.31 / $73.34 / $103.89
| Professional | | $65.31 | $73.34 | $103.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.33 / $112.49 / $184.22
| Professional | | $81.33 | $112.49 | $184.22 |