- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,000.00 / $4,168.69
| Facility | | $346.74 | $1,000.00 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $57.54 / $186.21
| Professional | | $30.20 | $57.54 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $58.88 / $138.04
| Professional | | $39.81 | $58.88 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $60.26
| Professional | | $32.36 | $33.11 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $741.31 / $1,659.59
| Facility | | $616.60 | $741.31 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $81.28 / $128.82
| Professional | | $42.66 | $81.28 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $75.86 / $158.49
| Professional | | $45.71 | $75.86 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $107.15 / $162.18
| Professional | | $39.81 | $107.15 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,466.84 / $5,128.61
| Facility | | $1,071.52 | $4,466.84 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $57.54 / $120.23
| Professional | | $33.11 | $57.54 | $120.23 |