- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $988.00 / $2,094.00 / $3,685.00
| Facility | | $988.00 | $2,094.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.93 / $52.66 / $75.91
| Professional | | $48.93 | $52.66 | $75.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.29 / $3,997.00 / $12,000.00
| Facility | | $116.29 | $3,997.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.28 / $92.52 / $550.76
| Professional | | $48.28 | $92.52 | $550.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.22 / $92.55 / $150.97
| Professional | | $67.22 | $92.55 | $150.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.06 / $98.83 / $216.56
| Professional | | $59.06 | $98.83 | $216.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.74 / $300.00 / $6,679.00
| Facility | | $56.74 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.53 / $54.71 / $88.21
| Professional | | $29.53 | $54.71 | $88.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.39 / $118.45 / $170.81
| Professional | | $59.39 | $118.45 | $170.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,320.31 / $4,320.31 / $4,320.31
| Facility | | $4,320.31 | $4,320.31 | $4,320.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.26 / $67.26 / $67.26
| Professional | | $67.26 | $67.26 | $67.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $4,525.00 / $12,000.00
| Facility | | $1,061.00 | $4,525.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.33 / $93.19 / $550.76
| Professional | | $57.33 | $93.19 | $550.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.87 / $73.83 / $180.81
| Professional | | $53.87 | $73.83 | $180.81 |