- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.35 / $2,079.00 / $3,685.00
| Facility | | $117.35 | $2,079.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.72 / $99.51 / $183.48
| Professional | | $34.72 | $99.51 | $183.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.81 / $953.00 / $2,733.00
| Facility | | $65.81 | $953.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.34 / $155.38 / $820.59
| Professional | | $35.34 | $155.38 | $820.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.51 / $47.46 / $93.28
| Facility | | $36.51 | $47.46 | $93.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.87 / $59.87 / $206.14
| Professional | | $59.87 | $59.87 | $206.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.23 / $151.13 / $321.26
| Professional | | $48.23 | $151.13 | $321.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.54 / $300.00 / $6,679.00
| Facility | | $36.54 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.64 / $148.97 / $265.77
| Professional | | $117.64 | $148.97 | $265.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.20 / $123.29 / $273.72
| Professional | | $38.20 | $123.29 | $273.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.96 / $311.19 / $820.59
| Professional | | $119.96 | $311.19 | $820.59 |
- 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
- $102.47 / $170.58 / $389.33
| Professional | | $102.47 | $170.58 | $389.33 |