- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.85 / $1,777.00 / $7,175.00
| Facility | | $93.85 | $1,777.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.10 / $90.21 / $175.62
| Professional | | $58.10 | $90.21 | $175.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.52 / $105.35 / $168.27
| Professional | | $101.52 | $105.35 | $168.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.63 / $108.62 / $187.50
| Professional | | $70.63 | $108.62 | $187.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.98 / $162.06 / $163.01
| Professional | | $121.98 | $162.06 | $163.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.78 / $1,774.82 / $3,153.32
| Facility | | $501.78 | $1,774.82 | $3,153.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.60 / $1,978.00 / $7,197.00
| Facility | | $461.60 | $1,978.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.13 / $106.23 / $226.42
| Professional | | $63.13 | $106.23 | $226.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $108.30 / $271.70
| Professional | | $3.00 | $108.30 | $271.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.31 / $110.14 / $187.54
| Professional | | $72.31 | $110.14 | $187.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.89 / $65.50 / $103.94
| Facility | | $63.89 | $65.50 | $103.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.89 / $98.47 / $107.55
| Professional | | $63.89 | $98.47 | $107.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.00 / $1,305.00 / $3,742.00
| Facility | | $435.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.66 / $116.86 / $192.56
| Professional | | $88.66 | $116.86 | $192.56 |