- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $2,238.72 / $5,128.61
| Facility | | $85.11 | $2,238.72 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $77.62 / $181.97
| Professional | | $56.23 | $77.62 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $4,677.35
| Facility | | $56.23 | $1,258.93 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $102.33 / $537.03
| Professional | | $58.88 | $102.33 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $70.79 / $162.18
| Facility | | $70.79 | $70.79 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $154.88 / $954.99
| Professional | | $123.03 | $154.88 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $199.53 / $501.19
| Facility | | $81.28 | $199.53 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $112.20 / $288.40
| Professional | | $61.66 | $112.20 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $177.83 / $7,079.46
| Facility | | $56.23 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $120.23 / $177.83
| Professional | | $83.18 | $120.23 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $109.65 / $194.98
| Professional | | $64.57 | $109.65 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $4,677.35
| Facility | | $56.23 | $1,258.93 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $100.00 / $537.03
| Professional | | $58.88 | $100.00 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,162.28 / $8,511.38
| Facility | | $676.08 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $104.71 / $199.53
| Professional | | $60.26 | $104.71 | $199.53 |