- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.61 / $2,070.00 / $7,629.00
| Facility | | $59.61 | $2,070.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.87 / $67.98 / $106.39
| Professional | | $51.87 | $67.98 | $106.39 |
- 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
- $69.54 / $72.16 / $109.10
| Professional | | $69.54 | $72.16 | $109.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.98 / $85.57 / $135.84
| Professional | | $60.98 | $85.57 | $135.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.81 / $108.41 / $108.78
| Professional | | $81.81 | $108.41 | $108.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $665.75 / $665.75 / $11,938.27
| Facility | | $665.75 | $665.75 | $11,938.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,266.00 / $8,017.00
| Facility | | $617.00 | $2,266.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.06 / $74.63 / $149.07
| Professional | | $56.06 | $74.63 | $149.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $98.90 / $170.50
| Professional | | $3.00 | $98.90 | $170.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.00 / $87.05 / $148.58
| Professional | | $62.00 | $87.05 | $148.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.53 / $64.03 / $82.08
| Facility | | $55.53 | $64.03 | $82.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.53 / $64.70 / $70.02
| Professional | | $55.53 | $64.70 | $70.02 |
- 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
- $69.61 / $87.01 / $139.32
| Professional | | $69.61 | $87.01 | $139.32 |