- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.54 / $1,829.00 / $7,197.00
| Facility | | $151.54 | $1,829.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.20 / $147.76 / $232.19
| Professional | | $100.20 | $147.76 | $232.19 |
- 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
- $165.30 / $239.98 / $279.64
| Professional | | $165.30 | $239.98 | $279.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.93 / $181.20 / $304.55
| Professional | | $121.93 | $181.20 | $304.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.39 / $263.66 / $264.36
| Professional | | $198.39 | $263.66 | $264.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.01 / $557.00 / $1,363.48
| Facility | | $310.01 | $557.00 | $1,363.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $2,029.00 / $7,799.00
| Facility | | $480.00 | $2,029.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.96 / $161.46 / $348.43
| Professional | | $106.96 | $161.46 | $348.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $231.00 / $437.40
| Professional | | $3.00 | $231.00 | $437.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.85 / $187.13 / $306.25
| Professional | | $124.85 | $187.13 | $306.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.20 / $137.57 / $173.34
| Facility | | $111.20 | $137.57 | $173.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.20 / $159.77 / $174.58
| Professional | | $111.20 | $159.77 | $174.58 |
- 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
- $149.55 / $195.42 / $314.85
| Professional | | $149.55 | $195.42 | $314.85 |