- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.31 / $1,544.00 / $7,175.00
| Facility | | $166.31 | $1,544.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.11 / $134.10 / $274.13
| Professional | | $69.11 | $134.10 | $274.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.43 / $179.97 / $243.00
| Professional | | $127.43 | $179.97 | $243.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $150.65 / $264.74
| Professional | | $85.11 | $150.65 | $264.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.22 / $229.42 / $234.96
| Professional | | $173.22 | $229.42 | $234.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.61 / $345.50 / $903.27
| Facility | | $200.61 | $345.50 | $903.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.97 / $1,741.00 / $7,197.00
| Facility | | $231.97 | $1,741.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.56 / $147.51 / $350.52
| Professional | | $75.56 | $147.51 | $350.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $151.10 / $399.40
| Professional | | $3.00 | $151.10 | $399.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.00 / $150.91 / $265.43
| Professional | | $86.00 | $150.91 | $265.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.31 / $99.79 / $154.37
| Facility | | $74.31 | $99.79 | $154.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.31 / $142.09 / $155.09
| Professional | | $74.31 | $142.09 | $155.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.58 / $171.72 / $276.37
| Professional | | $134.58 | $171.72 | $276.37 |