- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $1,633.00 / $8,104.00
| Facility | | $77.62 | $1,633.00 | $8,104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.90 / $87.23 / $166.84
| Professional | | $65.90 | $87.23 | $166.84 |
- 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
- $91.01 / $111.94 / $156.65
| Professional | | $91.01 | $111.94 | $156.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.15 / $106.42 / $174.75
| Professional | | $77.15 | $106.42 | $174.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.28 / $143.52 / $145.19
| Professional | | $108.28 | $143.52 | $145.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.52 / $518.66 / $826.71
| Facility | | $232.52 | $518.66 | $826.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.27 / $3,964.00 / $8,247.00
| Facility | | $530.27 | $3,964.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.78 / $96.98 / $231.42
| Professional | | $71.78 | $96.98 | $231.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $102.50 / $224.70
| Professional | | $3.00 | $102.50 | $224.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.84 / $109.65 / $183.19
| Professional | | $79.84 | $109.65 | $183.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.79 / $78.84 / $96.92
| Facility | | $71.79 | $78.84 | $96.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.79 / $85.06 / $92.60
| Professional | | $71.79 | $85.06 | $92.60 |
- 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
- $85.73 / $109.92 / $176.87
| Professional | | $85.73 | $109.92 | $176.87 |