- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.25 / $2,747.00 / $4,806.64
| Facility | | $75.25 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.25 / $97.11 / $219.79
| Professional | | $75.25 | $97.11 | $219.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.49 / $502.00 / $2,733.00
| Facility | | $163.49 | $502.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.98 / $173.28 / $666.80
| Professional | | $74.98 | $173.28 | $666.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.87 / $112.76 / $199.28
| Facility | | $86.87 | $112.76 | $199.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.40 / $82.40 / $103.75
| Professional | | $82.40 | $82.40 | $103.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.28 / $173.03 / $341.87
| Professional | | $109.28 | $173.03 | $341.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.76 / $241.79 / $6,679.00
| Facility | | $76.76 | $241.79 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.22 / $106.18 / $170.20
| Professional | | $57.22 | $106.18 | $170.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.04 / $196.06 / $277.18
| Professional | | $94.04 | $196.06 | $277.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.20 / $146.62 / $210.06
| Professional | | $56.20 | $146.62 | $210.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.36 / $266.18 / $666.80
| Professional | | $102.36 | $266.18 | $666.80 |
- 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
- $83.68 / $138.19 / $313.23
| Professional | | $83.68 | $138.19 | $313.23 |