- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.53 / $2,663.12 / $3,693.00
| Facility | | $58.53 | $2,663.12 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.53 / $93.82 / $321.20
| Professional | | $58.53 | $93.82 | $321.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.12 / $393.05 / $2,733.00
| Facility | | $126.12 | $393.05 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.97 / $144.11 / $655.60
| Professional | | $68.97 | $144.11 | $655.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.64 / $84.03 / $148.28
| Facility | | $64.64 | $84.03 | $148.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.02 / $138.08 / $225.07
| Professional | | $93.02 | $138.08 | $225.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.59 / $151.94 / $281.45
| Professional | | $81.59 | $151.94 | $281.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.14 / $168.26 / $6,679.00
| Facility | | $66.14 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.70 / $104.34 / $168.22
| Professional | | $56.70 | $104.34 | $168.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.79 / $154.63 / $249.16
| Professional | | $71.79 | $154.63 | $249.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.38 / $230.38 / $415.35
| Facility | | $230.38 | $230.38 | $415.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.57 / $136.00 / $176.10
| Professional | | $132.57 | $136.00 | $176.10 |
- 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
- $110.21 / $211.91 / $655.60
| Professional | | $110.21 | $211.91 | $655.60 |
- 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
- $102.53 / $143.68 / $302.26
| Professional | | $102.53 | $143.68 | $302.26 |