- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.82 / $1,886.00 / $3,625.00
| Facility | | $91.82 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.06 / $99.28 / $250.18
| Professional | | $67.06 | $99.28 | $250.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.01 / $1,339.09 / $3,804.00
| Facility | | $143.01 | $1,339.09 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.86 / $156.87 / $764.00
| Professional | | $71.86 | $156.87 | $764.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.91 / $97.38 / $171.84
| Facility | | $74.91 | $97.38 | $171.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.53 / $122.84 / $328.76
| Professional | | $35.53 | $122.84 | $328.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.98 / $173.28 / $315.74
| Professional | | $91.98 | $173.28 | $315.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.39 / $168.26 / $6,679.00
| Facility | | $76.39 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.29 / $118.16 / $190.49
| Professional | | $64.29 | $118.16 | $190.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.71 / $178.15 / $281.91
| Professional | | $82.71 | $178.15 | $281.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.81 / $883.12 / $966.05
| Facility | | $794.81 | $883.12 | $966.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.78 / $94.56 / $181.95
| Professional | | $49.78 | $94.56 | $181.95 |
- 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
- $111.87 / $198.33 / $764.00
| Professional | | $111.87 | $198.33 | $764.00 |
- 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
- $110.58 / $150.49 / $317.67
| Professional | | $110.58 | $150.49 | $317.67 |