- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.68 / $1,823.00 / $3,363.00
| Facility | | $53.68 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.67 / $100.70 / $215.70
| Professional | | $45.67 | $100.70 | $215.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.29 / $748.13 / $3,381.00
| Facility | | $116.29 | $748.13 | $3,381.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.37 / $192.35 / $927.20
| Professional | | $71.37 | $192.35 | $927.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.58 / $103.55 / $184.85
| Facility | | $80.58 | $103.55 | $184.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.82 / $179.01 / $345.89
| Professional | | $102.82 | $179.01 | $345.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.70 / $212.40 / $500.00
| Facility | | $168.70 | $212.40 | $500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.06 / $152.00 / $364.00
| Professional | | $66.06 | $152.00 | $364.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $168.26 / $6,679.00
| Facility | | $53.00 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.22 / $195.67 / $278.83
| Professional | | $150.22 | $195.67 | $278.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.06 / $158.91 / $352.82
| Professional | | $72.06 | $158.91 | $352.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.80 / $953.53 / $3,804.00
| Facility | | $275.80 | $953.53 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.47 / $302.70 / $927.20
| Professional | | $116.47 | $302.70 | $927.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $1,878.00 / $4,142.00
| Facility | | $540.00 | $1,878.00 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.42 / $181.59 / $438.06
| Professional | | $103.42 | $181.59 | $438.06 |