- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.60 / $1,886.00 / $3,625.00
| Facility | | $86.60 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.44 / $261.47 / $427.17
| Professional | | $82.44 | $261.47 | $427.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $537.36 / $2,707.00
| Facility | | $55.00 | $537.36 | $2,707.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.50 / $533.55 / $1,968.18
| Professional | | $117.50 | $533.55 | $1,968.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.93 / $129.90 / $257.88
| Facility | | $100.93 | $129.90 | $257.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.36 / $168.73 / $717.71
| Professional | | $35.36 | $168.73 | $717.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.08 / $290.93 / $748.00
| Facility | | $231.08 | $290.93 | $748.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.21 / $320.63 / $918.96
| Professional | | $111.21 | $320.63 | $918.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.57 / $506.00 / $6,679.00
| Facility | | $87.57 | $506.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.94 / $493.56 / $787.52
| Professional | | $376.94 | $493.56 | $787.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.80 / $337.71 / $880.04
| Professional | | $129.80 | $337.71 | $880.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $528.00 / $2,733.00
| Facility | | $55.00 | $528.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.56 / $729.91 / $2,311.12
| Professional | | $404.56 | $729.91 | $2,311.12 |
- 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
- $343.88 / $543.66 / $1,311.95
| Professional | | $343.88 | $543.66 | $1,311.95 |