- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.30 / $1,919.00 / $3,469.00
| Facility | | $112.30 | $1,919.00 | $3,469.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.93 / $151.75 / $403.00
| Professional | | $93.93 | $151.75 | $403.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.31 / $449.07 / $2,733.00
| Facility | | $201.31 | $449.07 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.17 / $215.71 / $909.76
| Professional | | $97.17 | $215.71 | $909.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.54 / $137.19 / $242.11
| Facility | | $105.54 | $137.19 | $242.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.46 / $210.66 / $312.64
| Professional | | $134.46 | $210.66 | $312.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.00 / $213.67 / $418.83
| Professional | | $114.00 | $213.67 | $418.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.64 / $192.44 / $6,679.00
| Facility | | $91.64 | $192.44 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.76 / $144.84 / $233.51
| Professional | | $78.76 | $144.84 | $233.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.04 / $246.66 / $344.76
| Professional | | $115.04 | $246.66 | $344.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.44 / $384.56 / $843.12
| Facility | | $375.44 | $384.56 | $843.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.05 / $206.14 / $410.24
| Professional | | $143.05 | $206.14 | $410.24 |
- 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
- $144.07 / $286.95 / $909.76
| Professional | | $144.07 | $286.95 | $909.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.10 / $188.03 / $377.49
| Professional | | $138.10 | $188.03 | $377.49 |