- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.83 / $2,410.00 / $3,625.00
| Facility | | $78.83 | $2,410.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.78 / $78.83 / $205.95
| Professional | | $38.78 | $78.83 | $205.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.84 / $417.43 / $2,713.00
| Facility | | $81.84 | $417.43 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.36 / $190.05 / $838.40
| Professional | | $43.36 | $190.05 | $838.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.45 / $50.06 / $90.50
| Facility | | $39.45 | $50.06 | $90.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.72 / $143.08 / $285.58
| Professional | | $55.72 | $143.08 | $285.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.04 / $121.79 / $309.89
| Professional | | $49.04 | $121.79 | $309.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.60 / $83.43 / $8,090.00
| Facility | | $40.60 | $83.43 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.24 / $176.09 / $298.70
| Professional | | $135.24 | $176.09 | $298.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.42 / $121.16 / $355.01
| Professional | | $49.42 | $121.16 | $355.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.89 / $519.65 / $1,403.19
| Facility | | $199.89 | $519.65 | $1,403.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.00 / $100.51 / $200.37
| Professional | | $53.00 | $100.51 | $200.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.69 / $953.00 / $2,796.00
| Facility | | $297.69 | $953.00 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.47 / $285.08 / $838.40
| Professional | | $135.47 | $285.08 | $838.40 |
- 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
- $124.15 / $190.05 / $362.86
| Professional | | $124.15 | $190.05 | $362.86 |