- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.45 / $1,886.00 / $3,625.00
| Facility | | $121.45 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.47 / $123.82 / $316.95
| Professional | | $92.47 | $123.82 | $316.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.75 / $640.30 / $2,713.00
| Facility | | $207.75 | $640.30 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.22 / $219.05 / $958.48
| Professional | | $101.22 | $219.05 | $958.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.39 / $134.41 / $237.18
| Facility | | $103.39 | $134.41 | $237.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.94 / $206.37 / $290.77
| Professional | | $144.94 | $206.37 | $290.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.52 / $220.49 / $415.79
| Professional | | $126.52 | $220.49 | $415.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.18 / $188.52 / $6,679.00
| Facility | | $90.18 | $188.52 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.97 / $152.65 / $246.11
| Professional | | $82.97 | $152.65 | $246.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.78 / $244.98 / $364.65
| Professional | | $113.78 | $244.98 | $364.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.43 / $522.80 / $3,236.69
| Facility | | $0.43 | $522.80 | $3,236.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.96 / $215.93 / $340.00
| Professional | | $140.96 | $215.93 | $340.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.79 / $331.01 / $958.48
| Professional | | $154.79 | $331.01 | $958.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.84 / $1,149.64 / $2,733.00
| Facility | | $429.84 | $1,149.64 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.94 / $184.94 / $398.98
| Professional | | $145.94 | $184.94 | $398.98 |