- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.66 / $1,544.00 / $6,012.00
| Facility | | $103.66 | $1,544.00 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $77.95 / $173.53
| Professional | | $39.81 | $77.95 | $173.53 |
- 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
- $125.87 / $134.36 / $134.36
| Professional | | $125.87 | $134.36 | $134.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.43 / $92.73 / $166.99
| Professional | | $52.43 | $92.73 | $166.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.33 / $212.98 / $212.98
| Professional | | $159.33 | $212.98 | $212.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.62 / $833.04 / $1,706.94
| Facility | | $572.62 | $833.04 | $1,706.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.69 / $1,633.00 / $7,175.00
| Facility | | $154.69 | $1,633.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.17 / $87.37 / $221.83
| Professional | | $43.17 | $87.37 | $221.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $97.00 / $285.39
| Professional | | $3.00 | $97.00 | $285.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.43 / $92.73 / $169.96
| Professional | | $52.43 | $92.73 | $169.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.33 / $49.42 / $102.45
| Facility | | $43.33 | $49.42 | $102.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.33 / $82.96 / $110.55
| Professional | | $43.33 | $82.96 | $110.55 |
- 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
- $78.37 / $109.27 / $187.34
| Professional | | $78.37 | $109.27 | $187.34 |