- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.07 / $7,146.30 / $20,135.00
| Facility | | $105.07 | $7,146.30 | $20,135.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.75 / $96.45 / $312.60
| Professional | | $53.75 | $96.45 | $312.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $4,465.00 / $9,381.00
| Facility | | $1,615.00 | $4,465.00 | $9,381.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $152.54 / $291.68
| Professional | | $85.11 | $152.54 | $291.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.09 / $100.00 / $27,955.87
| Facility | | $77.09 | $100.00 | $27,955.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.43 / $111.95 / $207.98
| Professional | | $66.43 | $111.95 | $207.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.19 / $101.46 / $214.09
| Professional | | $60.19 | $101.46 | $214.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.69 / $57.27 / $124.36
| Professional | | $25.69 | $57.27 | $124.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.56 / $87.27 / $152.91
| Professional | | $51.56 | $87.27 | $152.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $234.66 / $253.46
| Facility | | $55.00 | $234.66 | $253.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.92 / $1,029.88 / $1,060.78
| Professional | | $383.92 | $1,029.88 | $1,060.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.36 / $92.37 / $177.51
| Facility | | $53.36 | $92.37 | $177.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.39 / $103.76 / $216.12
| Professional | | $60.39 | $103.76 | $216.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.42 / $176.42 / $273.79
| Professional | | $176.42 | $176.42 | $273.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.00 / $1,523.00 / $6,920.00
| Facility | | $526.00 | $1,523.00 | $6,920.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.70 / $108.56 / $259.66
| Professional | | $68.70 | $108.56 | $259.66 |