- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.08 / $1,886.00 / $3,625.00
| Facility | | $143.08 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.23 / $143.08 / $246.06
| Professional | | $50.23 | $143.08 | $246.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.63 / $1,339.09 / $4,142.00
| Facility | | $149.63 | $1,339.09 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.20 / $271.30 / $6,897.85
| Professional | | $75.20 | $271.30 | $6,897.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.69 / $101.00 / $198.11
| Facility | | $77.69 | $101.00 | $198.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.13 / $192.78 / $419.43
| Professional | | $99.13 | $192.78 | $419.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.90 / $265.39 / $516.19
| Professional | | $119.90 | $265.39 | $516.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.75 / $213.38 / $6,679.00
| Facility | | $67.75 | $213.38 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.93 / $231.16 / $413.30
| Professional | | $182.93 | $231.16 | $413.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.39 / $193.33 / $429.21
| Professional | | $84.39 | $193.33 | $429.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $144.54 / $149.86
| Facility | | $144.54 | $144.54 | $149.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.64 / $102.64 / $106.92
| Professional | | $102.64 | $102.64 | $106.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,878.00 / $7,161.00
| Facility | | $55.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.13 / $434.09 / $6,897.85
| Professional | | $235.13 | $434.09 | $6,897.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.28 / $291.79 / $529.01
| Professional | | $199.28 | $291.79 | $529.01 |