- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.34 / $1,473.20 / $3,363.00
| Facility | | $127.34 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.01 / $177.97 / $457.96
| Professional | | $93.01 | $177.97 | $457.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.89 / $556.13 / $2,733.00
| Facility | | $252.89 | $556.13 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.89 / $295.07 / $1,321.28
| Professional | | $124.89 | $295.07 | $1,321.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.50 / $169.65 / $299.37
| Facility | | $130.50 | $169.65 | $299.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.13 / $285.82 / $573.26
| Professional | | $65.13 | $285.82 | $573.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.94 / $272.45 / $538.34
| Professional | | $143.94 | $272.45 | $538.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.03 / $300.00 / $6,679.00
| Facility | | $112.03 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.37 / $213.07 / $336.17
| Professional | | $117.37 | $213.07 | $336.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.38 / $300.24 / $501.72
| Professional | | $139.38 | $300.24 | $501.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.58 / $566.23 / $1,013.45
| Facility | | $120.58 | $566.23 | $1,013.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.43 / $176.28 / $344.63
| Professional | | $140.43 | $176.28 | $344.63 |
- 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
- $184.31 / $427.07 / $1,321.28
| Professional | | $184.31 | $427.07 | $1,321.28 |
- 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
- $177.49 / $245.05 / $566.23
| Professional | | $177.49 | $245.05 | $566.23 |