- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.40 / $1,823.00 / $3,363.00
| Facility | | $145.40 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.15 / $145.40 / $280.77
| Professional | | $62.15 | $145.40 | $280.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.68 / $1,339.09 / $4,142.00
| Facility | | $154.68 | $1,339.09 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.76 / $280.24 / $1,378.98
| Professional | | $88.76 | $280.24 | $1,378.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.80 / $103.74 / $203.49
| Facility | | $79.80 | $103.74 | $203.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.82 / $186.57 / $427.72
| Professional | | $101.82 | $186.57 | $427.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.09 / $270.63 / $479.53
| Professional | | $125.09 | $270.63 | $479.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.34 / $270.02 / $6,679.00
| Facility | | $81.34 | $270.02 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.74 / $235.97 / $421.90
| Professional | | $186.74 | $235.97 | $421.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.91 / $197.43 / $438.31
| Professional | | $86.91 | $197.43 | $438.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.50 / $116.03 / $158.10
| Facility | | $110.50 | $116.03 | $158.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.88 / $100.51 / $111.76
| Professional | | $55.88 | $100.51 | $111.76 |
- 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
- $222.63 / $448.39 / $1,378.98
| Professional | | $222.63 | $448.39 | $1,378.98 |
- 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
- $215.44 / $309.42 / $565.21
| Professional | | $215.44 | $309.42 | $565.21 |