- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.31 / $1,519.00 / $8,017.00
| Facility | | $82.31 | $1,519.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.27 / $80.43 / $154.32
| Professional | | $51.27 | $80.43 | $154.32 |
- 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
- $89.84 / $93.22 / $154.09
| Professional | | $89.84 | $93.22 | $154.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.53 / $98.26 / $166.33
| Professional | | $62.53 | $98.26 | $166.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.73 / $143.10 / $143.87
| Professional | | $107.73 | $143.10 | $143.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.18 / $529.00 / $903.11
| Facility | | $385.18 | $529.00 | $903.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.21 / $3,839.00 / $8,247.00
| Facility | | $200.21 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.68 / $90.26 / $207.75
| Professional | | $54.68 | $90.26 | $207.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $117.30 / $237.50
| Professional | | $95.50 | $117.30 | $237.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.94 / $101.44 / $171.51
| Professional | | $62.94 | $101.44 | $171.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.70 / $61.72 / $89.27
| Facility | | $56.70 | $61.72 | $89.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.70 / $84.81 / $95.08
| Professional | | $56.70 | $84.81 | $95.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $557.00 / $3,742.00
| Facility | | $162.00 | $557.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.27 / $111.62 / $188.69
| Professional | | $81.27 | $111.62 | $188.69 |