- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.93 / $1,823.00 / $3,363.00
| Facility | | $87.93 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.78 / $113.00 / $183.48
| Professional | | $82.78 | $113.00 | $183.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.12 / $543.90 / $2,391.00
| Facility | | $64.12 | $543.90 | $2,391.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.11 / $210.63 / $733.41
| Professional | | $98.11 | $210.63 | $733.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.57 / $120.24 / $214.46
| Facility | | $93.57 | $120.24 | $214.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.44 / $153.44 / $195.23
| Professional | | $153.44 | $153.44 | $195.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $102.05 / $122.41
| Facility | | $50.00 | $102.05 | $122.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.66 / $183.99 / $398.19
| Professional | | $96.66 | $183.99 | $398.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.62 / $170.60 / $6,679.00
| Facility | | $80.62 | $170.60 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.34 / $146.53 / $232.80
| Professional | | $114.34 | $146.53 | $232.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.10 / $209.79 / $273.85
| Professional | | $104.10 | $209.79 | $273.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.72 / $251.72 / $251.72
| Professional | | $251.72 | $251.72 | $251.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $627.00 / $2,733.00
| Facility | | $55.00 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.79 / $294.70 / $733.41
| Professional | | $129.79 | $294.70 | $733.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $1,078.00 / $2,733.00
| Facility | | $308.00 | $1,078.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.65 / $173.60 / $427.77
| Professional | | $120.65 | $173.60 | $427.77 |