- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.50 / $2,083.00 / $3,625.00
| Facility | | $123.50 | $2,083.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.43 / $132.66 / $195.07
| Professional | | $120.43 | $132.66 | $195.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $609.00 / $2,713.00
| Facility | | $55.00 | $609.00 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.37 / $239.29 / $907.20
| Professional | | $135.37 | $239.29 | $907.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.43 / $139.43 / $1,708.85
| Professional | | $139.43 | $139.43 | $1,708.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.00 / $680.00 / $1,915.00
| Facility | | $680.00 | $680.00 | $1,915.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.51 / $236.09 / $441.67
| Professional | | $146.51 | $236.09 | $441.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.89 / $214.32 / $6,679.00
| Facility | | $124.89 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.31 / $181.09 / $279.85
| Professional | | $143.31 | $181.09 | $279.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.33 / $311.97 / $384.62
| Professional | | $159.33 | $311.97 | $384.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.52 / $39.52 / $39.52
| Professional | | $39.52 | $39.52 | $39.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $610.79 / $2,733.00
| Facility | | $55.00 | $610.79 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.96 / $242.64 / $907.20
| Professional | | $145.96 | $242.64 | $907.20 |
- 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
- $140.88 / $203.07 / $482.29
| Professional | | $140.88 | $203.07 | $482.29 |