- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.81 / $2,747.00 / $8,247.00
| Facility | | $63.81 | $2,747.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.28 / $90.92 / $142.38
| Professional | | $57.28 | $90.92 | $142.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.47 / $87.26 / $140.19
| Professional | | $81.47 | $87.26 | $140.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.24 / $93.83 / $180.16
| Professional | | $58.24 | $93.83 | $180.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.28 / $130.28 / $134.75
| Professional | | $130.28 | $130.28 | $134.75 |
- 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
- $57.28 / $91.12 / $284.31
| Professional | | $57.28 | $91.12 | $284.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $86.50 / $222.00
| Professional | | $4.00 | $86.50 | $222.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.01 / $95.20 / $180.16
| Professional | | $59.01 | $95.20 | $180.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.04 / $83.02 / $190.91
| Facility | | $52.04 | $83.02 | $190.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.04 / $81.43 / $123.62
| Professional | | $52.04 | $81.43 | $123.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $650.00 / $3,742.00
| Facility | | $144.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.65 / $115.03 / $183.84
| Professional | | $76.65 | $115.03 | $183.84 |