- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.85 / $1,143.45 / $2,747.00
| Facility | | $127.85 | $1,143.45 | $2,747.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.64 / $131.58 / $506.51
| Professional | | $55.64 | $131.58 | $506.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.85 / $627.00 / $2,733.00
| Facility | | $127.85 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.75 / $334.50 / $2,976.11
| Professional | | $73.75 | $334.50 | $2,976.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.87 / $86.94 / $173.07
| Facility | | $67.87 | $86.94 | $173.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.83 / $86.47 / $499.06
| Professional | | $27.83 | $86.47 | $499.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.34 / $208.94 / $569.96
| Professional | | $70.34 | $208.94 | $569.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.25 / $196.09 / $6,679.00
| Facility | | $62.25 | $196.09 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.07 / $269.66 / $438.47
| Professional | | $146.07 | $269.66 | $438.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.43 / $216.98 / $657.00
| Professional | | $82.43 | $216.98 | $657.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.38 / $142.96 / $1,539.79
| Facility | | $110.38 | $142.96 | $1,539.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.00 / $176.10 / $834.02
| Professional | | $90.00 | $176.10 | $834.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $953.00 / $2,796.00
| Facility | | $308.00 | $953.00 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.58 / $544.29 / $2,976.11
| Professional | | $199.58 | $544.29 | $2,976.11 |
- 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
- $191.20 / $324.66 / $789.75
| Professional | | $191.20 | $324.66 | $789.75 |