- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.24 / $1,823.00 / $3,363.00
| Facility | | $154.24 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.34 / $112.05 / $225.62
| Professional | | $36.34 | $112.05 | $225.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.09 / $627.00 / $2,733.00
| Facility | | $81.09 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.05 / $266.11 / $1,248.08
| Professional | | $46.05 | $266.11 | $1,248.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.36 / $52.98 / $105.47
| Facility | | $41.36 | $52.98 | $105.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.42 / $215.91 / $430.96
| Professional | | $58.42 | $215.91 | $430.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.53 / $120.00 / $455.86
| Professional | | $46.53 | $120.00 | $455.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.52 / $83.43 / $8,090.00
| Facility | | $42.52 | $83.43 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.86 / $265.61 / $410.73
| Professional | | $202.86 | $265.61 | $410.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.35 / $138.44 / $472.86
| Professional | | $51.35 | $138.44 | $472.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.50 / $67.50 / $410.53
| Facility | | $67.50 | $67.50 | $410.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.94 / $57.88 / $285.64
| Professional | | $28.94 | $57.88 | $285.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $953.00 / $2,796.00
| Facility | | $308.00 | $953.00 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.87 / $400.27 / $1,248.08
| Professional | | $172.87 | $400.27 | $1,248.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.20 / $277.20 / $652.08
| Professional | | $80.20 | $277.20 | $652.08 |