- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.69 / $2,747.00 / $8,113.00
| Facility | | $42.69 | $2,747.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.44 / $65.27 / $109.93
| Professional | | $35.44 | $65.27 | $109.93 |
- 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
- $72.98 / $75.75 / $129.10
| Professional | | $72.98 | $75.75 | $129.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.61 / $76.88 / $137.01
| Professional | | $42.61 | $76.88 | $137.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.57 / $115.96 / $118.96
| Professional | | $87.57 | $115.96 | $118.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.79 / $546.79 / $546.79
| Facility | | $546.79 | $546.79 | $546.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $4,264.00 / $8,247.00
| Facility | | $540.00 | $4,264.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.07 / $72.09 / $184.33
| Professional | | $37.07 | $72.09 | $184.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $162.80 / $194.40
| Professional | | $3.00 | $162.80 | $194.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.17 / $78.81 / $147.78
| Professional | | $44.17 | $78.81 | $147.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.47 / $53.43 / $82.57
| Facility | | $39.47 | $53.43 | $82.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.47 / $70.31 / $76.84
| Professional | | $39.47 | $70.31 | $76.84 |
- 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
- $66.53 / $85.55 / $136.25
| Professional | | $66.53 | $85.55 | $136.25 |