- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.00 / $1,823.00 / $3,363.00
| Facility | | $177.00 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.46 / $105.66 / $241.36
| Professional | | $57.46 | $105.66 | $241.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.54 / $679.46 / $2,733.00
| Facility | | $82.54 | $679.46 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.24 / $170.73 / $546.60
| Professional | | $39.24 | $170.73 | $546.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.57 / $55.34 / $108.55
| Facility | | $42.57 | $55.34 | $108.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.26 / $162.19 / $253.26
| Professional | | $61.26 | $162.19 | $253.26 |
- 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
- $64.70 / $191.05 / $332.53
| Professional | | $64.70 | $191.05 | $332.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.03 / $250.87 / $6,679.00
| Facility | | $44.03 | $250.87 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.15 / $168.65 / $301.52
| Professional | | $142.15 | $168.65 | $301.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.69 / $141.72 / $340.55
| Professional | | $46.69 | $141.72 | $340.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.78 / $88.78 / $88.78
| Professional | | $88.78 | $88.78 | $88.78 |
- 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
- $153.68 / $280.20 / $851.67
| Professional | | $153.68 | $280.20 | $851.67 |
- 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
- $150.87 / $214.45 / $352.97
| Professional | | $150.87 | $214.45 | $352.97 |