- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.27 / $2,017.50 / $8,017.00
| Facility | | $156.27 | $2,017.50 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.21 / $137.84 / $193.44
| Professional | | $57.21 | $137.84 | $193.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $990.00 / $2,594.00 / $5,296.01
| Facility | | $990.00 | $2,594.00 | $5,296.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.97 / $202.75 / $300.98
| Professional | | $134.97 | $202.75 | $300.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.01 / $151.96 / $315.60
| Professional | | $65.01 | $151.96 | $315.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.46 / $244.09 / $252.72
| Professional | | $184.46 | $244.09 | $252.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.66 / $1,887.59 / $76,189.25
| Facility | | $636.66 | $1,887.59 | $76,189.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,266.00 / $8,017.00
| Facility | | $540.00 | $2,266.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.34 / $138.09 / $363.59
| Professional | | $60.34 | $138.09 | $363.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $266.89 / $417.50
| Professional | | $5.00 | $266.89 | $417.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.28 / $157.97 / $317.01
| Professional | | $69.28 | $157.97 | $317.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.87 / $97.07 / $202.66
| Facility | | $65.87 | $97.07 | $202.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.87 / $147.25 / $160.81
| Professional | | $65.87 | $147.25 | $160.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $1,305.00 / $3,742.00
| Facility | | $471.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.54 / $205.12 / $324.14
| Professional | | $156.54 | $205.12 | $324.14 |