- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.87 / $1,823.00 / $3,363.00
| Facility | | $88.87 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.71 / $154.36 / $261.89
| Professional | | $87.71 | $154.36 | $261.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.99 / $1,689.00 / $12,000.00
| Facility | | $280.99 | $1,689.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.94 / $324.02 / $1,478.72
| Professional | | $135.94 | $324.02 | $1,478.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.97 / $178.59 / $318.82
| Facility | | $138.97 | $178.59 | $318.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $633.32 / $711.49 / $711.49
| Professional | | $633.32 | $711.49 | $711.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $1,408.94
| Facility | | $443.00 | $500.00 | $1,408.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.53 / $264.35 / $557.52
| Professional | | $121.53 | $264.35 | $557.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.04 / $377.00 / $6,679.00
| Facility | | $90.04 | $377.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.31 / $312.44 / $451.31
| Professional | | $240.31 | $312.44 | $451.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.25 / $256.02 / $568.35
| Professional | | $134.25 | $256.02 | $568.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.30 / $2,338.00 / $12,000.00
| Facility | | $508.30 | $2,338.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.88 / $503.27 / $1,478.72
| Professional | | $222.88 | $503.27 | $1,478.72 |
- 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
- $208.39 / $326.72 / $687.16
| Professional | | $208.39 | $326.72 | $687.16 |