- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.85 / $1,473.20 / $3,363.00
| Facility | | $201.85 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.39 / $97.04 / $318.82
| Professional | | $36.39 | $97.04 | $318.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.93 / $809.82 / $2,733.00
| Facility | | $135.93 | $809.82 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.90 / $217.79 / $934.24
| Professional | | $90.90 | $217.79 | $934.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.43 / $98.06 / $192.35
| Facility | | $75.43 | $98.06 | $192.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.93 / $150.50 / $316.69
| Professional | | $30.93 | $150.50 | $316.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.47 / $141.21 / $282.75
| Professional | | $74.47 | $141.21 | $282.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.91 / $145.15 / $6,679.00
| Facility | | $65.91 | $145.15 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.00 / $151.33 / $224.20
| Professional | | $83.00 | $151.33 | $224.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.81 / $181.85 / $361.09
| Professional | | $84.81 | $181.85 | $361.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.30 / $389.67 / $524.57
| Facility | | $281.30 | $389.67 | $524.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.24 / $69.69 / $165.58
| Professional | | $59.24 | $69.69 | $165.58 |
- 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
- $104.44 / $252.27 / $934.24
| Professional | | $104.44 | $252.27 | $934.24 |
- 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
- $103.95 / $155.36 / $316.70
| Professional | | $103.95 | $155.36 | $316.70 |