- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.74 / $1,886.00 / $3,625.00
| Facility | | $59.74 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.92 / $74.18 / $111.43
| Professional | | $54.92 | $74.18 | $111.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $905.10 / $4,569.00
| Facility | | $55.00 | $905.10 | $4,569.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.86 / $144.01 / $538.79
| Professional | | $67.86 | $144.01 | $538.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.34 / $91.67 / $163.51
| Facility | | $71.34 | $91.67 | $163.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.99 / $928.83 / $928.83
| Professional | | $116.99 | $928.83 | $928.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.77 / $97.92 / $500.00
| Facility | | $77.77 | $97.92 | $500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.81 / $124.02 / $265.39
| Professional | | $70.81 | $124.02 | $265.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.19 / $168.26 / $6,679.00
| Facility | | $61.19 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.17 / $110.81 / $183.61
| Professional | | $86.17 | $110.81 | $183.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.34 / $157.78 / $204.13
| Professional | | $78.34 | $157.78 | $204.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,385.60 / $4,755.00
| Facility | | $55.00 | $1,385.60 | $4,755.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.59 / $190.96 / $538.79
| Professional | | $91.59 | $190.96 | $538.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.00 / $2,338.00 / $4,952.00
| Facility | | $669.00 | $2,338.00 | $4,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.20 / $123.27 / $316.83
| Professional | | $81.20 | $123.27 | $316.83 |