- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.36 / $2,266.00 / $7,197.00
| Facility | | $155.36 | $2,266.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.84 / $121.65 / $242.92
| Professional | | $63.84 | $121.65 | $242.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.57 / $139.65 / $139.65
| Professional | | $134.57 | $139.65 | $139.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.59 / $134.97 / $252.78
| Professional | | $71.59 | $134.97 | $252.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.68 / $217.13 / $223.05
| Professional | | $163.68 | $217.13 | $223.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,813.06 / $3,813.06 / $6,649.71
| Facility | | $3,813.06 | $3,813.06 | $6,649.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,422.00 / $7,799.00
| Facility | | $617.00 | $2,422.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.17 / $136.31 / $401.79
| Professional | | $64.17 | $136.31 | $401.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $102.10 / $385.40
| Professional | | $4.00 | $102.10 | $385.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.11 / $139.00 / $266.27
| Professional | | $74.11 | $139.00 | $266.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.89 / $87.22 / $137.03
| Facility | | $65.89 | $87.22 | $137.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.84 / $133.26 / $148.08
| Professional | | $65.84 | $133.26 | $148.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.22 / $159.30 / $274.87
| Professional | | $108.22 | $159.30 | $274.87 |