- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.15 / $988.00 / $3,103.52
| Facility | | $82.15 | $988.00 | $3,103.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.05 / $111.50 / $340.52
| Professional | | $55.05 | $111.50 | $340.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.30 / $502.00 / $2,713.00
| Facility | | $100.30 | $502.00 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.84 / $141.90 / $1,797.00
| Professional | | $64.84 | $141.90 | $1,797.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.56 / $62.89 / $113.59
| Facility | | $49.56 | $62.89 | $113.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.14 / $122.27 / $214.21
| Professional | | $63.14 | $122.27 | $214.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $75.00 / $75.00
| Facility | | $75.00 | $75.00 | $75.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.78 / $129.12 / $238.33
| Professional | | $58.78 | $129.12 | $238.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.23 / $168.26 / $6,679.00
| Facility | | $51.23 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.06 / $102.40 / $172.20
| Professional | | $54.06 | $102.40 | $172.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.32 / $123.31 / $251.31
| Professional | | $63.32 | $123.31 | $251.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.99 / $394.04 / $4,822.20
| Facility | | $307.99 | $394.04 | $4,822.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.10 / $33.94 / $159.41
| Professional | | $33.10 | $33.94 | $159.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.34 / $953.00 / $2,796.00
| Facility | | $219.34 | $953.00 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.20 / $188.78 / $1,797.00
| Professional | | $96.20 | $188.78 | $1,797.00 |
- 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
- $87.89 / $143.75 / $247.82
| Professional | | $87.89 | $143.75 | $247.82 |