- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.92 / $1,633.00 / $7,317.00
| Facility | | $254.92 | $1,633.00 | $7,317.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.75 / $116.34 / $404.00
| Professional | | $80.75 | $116.34 | $404.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.33 / $159.33 / $229.68
| Professional | | $159.33 | $159.33 | $229.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.52 / $129.22 / $195.75
| Professional | | $124.52 | $129.22 | $195.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.93 / $139.71 / $226.13
| Professional | | $96.93 | $139.71 | $226.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.33 / $198.32 / $199.71
| Professional | | $149.33 | $198.32 | $199.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.00 / $434.03 / $929.11
| Facility | | $167.00 | $434.03 | $929.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.94 / $2,543.00 / $8,017.00
| Facility | | $516.94 | $2,543.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.21 / $152.71 / $368.00
| Professional | | $88.21 | $152.71 | $368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $114.20 / $331.80
| Professional | | $3.00 | $114.20 | $331.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.04 / $143.09 / $230.40
| Professional | | $99.04 | $143.09 | $230.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.86 / $110.56 / $130.65
| Facility | | $88.86 | $110.56 | $130.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.86 / $120.87 / $132.09
| Professional | | $88.86 | $120.87 | $132.09 |
- 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
- $109.48 / $144.32 / $240.72
| Professional | | $109.48 | $144.32 | $240.72 |