- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.83 / $1,819.00 / $7,197.00
| Facility | | $95.83 | $1,819.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.71 / $78.41 / $143.77
| Professional | | $56.71 | $78.41 | $143.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $5,044.89
| Facility | | $1,083.51 | $1,395.00 | $5,044.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.88 / $91.20 / $157.91
| Professional | | $87.88 | $91.20 | $157.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.43 / $100.71 / $165.00
| Professional | | $67.43 | $100.71 | $165.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.24 / $138.15 / $139.59
| Professional | | $104.24 | $138.15 | $139.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.00 / $568.13 / $1,091.79
| Facility | | $193.00 | $568.13 | $1,091.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.43 / $1,978.00 / $7,799.00
| Facility | | $130.43 | $1,978.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.10 / $89.69 / $284.61
| Professional | | $62.10 | $89.69 | $284.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $192.10 / $226.90
| Professional | | $3.00 | $192.10 | $226.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.30 / $103.43 / $176.90
| Professional | | $69.30 | $103.43 | $176.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.35 / $75.73 / $99.08
| Facility | | $62.35 | $75.73 | $99.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.35 / $84.15 / $91.54
| Professional | | $62.35 | $84.15 | $91.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $557.00 / $3,742.00
| Facility | | $162.00 | $557.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.81 / $103.98 / $178.42
| Professional | | $83.81 | $103.98 | $178.42 |