- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.82 / $2,067.00 / $3,625.00
| Facility | | $86.82 | $2,067.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.44 / $87.40 / $167.58
| Professional | | $65.44 | $87.40 | $167.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.30 / $736.00 / $7,231.00
| Facility | | $152.30 | $736.00 | $7,231.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.04 / $152.72 / $1,950.30
| Professional | | $67.04 | $152.72 | $1,950.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.73 / $94.56 / $166.87
| Facility | | $72.73 | $94.56 | $166.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.44 / $162.84 / $327.83
| Professional | | $93.44 | $162.84 | $327.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.33 / $168.26 / $6,679.00
| Facility | | $74.33 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.94 / $105.75 / $163.80
| Professional | | $54.94 | $105.75 | $163.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.19 / $171.93 / $244.84
| Professional | | $80.19 | $171.93 | $244.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,436.96 / $4,436.96 / $4,436.96
| Facility | | $4,436.96 | $4,436.96 | $4,436.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.99 / $96.99 / $96.99
| Professional | | $96.99 | $96.99 | $96.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.75 / $2,028.00 / $11,500.00
| Facility | | $309.75 | $2,028.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.01 / $221.14 / $1,950.30
| Professional | | $101.01 | $221.14 | $1,950.30 |
- 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
- $88.01 / $136.71 / $310.55
| Professional | | $88.01 | $136.71 | $310.55 |