- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.01 / $1,686.85 / $3,363.00
| Facility | | $548.01 | $1,686.85 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.74 / $127.46 / $351.74
| Professional | | $60.74 | $127.46 | $351.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.33 / $712.10 / $3,804.00
| Facility | | $130.33 | $712.10 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.36 / $150.90 / $699.92
| Professional | | $71.36 | $150.90 | $699.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.29 / $87.48 / $154.36
| Facility | | $67.29 | $87.48 | $154.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.83 / $134.31 / $304.98
| Professional | | $63.83 | $134.31 | $304.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.85 / $158.22 / $291.17
| Professional | | $84.85 | $158.22 | $291.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.69 / $300.00 / $6,679.00
| Facility | | $68.69 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.64 / $109.55 / $176.62
| Professional | | $59.64 | $109.55 | $176.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.31 / $160.07 / $261.00
| Professional | | $74.31 | $160.07 | $261.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $745.87 / $846.22 / $3,013.47
| Facility | | $745.87 | $846.22 | $3,013.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.55 / $146.68 / $204.36
| Professional | | $47.55 | $146.68 | $204.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,878.00 / $7,161.00
| Facility | | $55.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.94 / $220.49 / $699.92
| Professional | | $111.94 | $220.49 | $699.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.47 / $145.94 / $292.45
| Professional | | $104.47 | $145.94 | $292.45 |