- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.36 / $1,886.00 / $3,625.00
| Facility | | $81.36 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.56 / $100.05 / $293.73
| Professional | | $55.56 | $100.05 | $293.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.94 / $1,251.81 / $3,804.00
| Facility | | $167.94 | $1,251.81 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.58 / $190.66 / $973.08
| Professional | | $83.58 | $190.66 | $973.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.68 / $111.38 / $196.55
| Facility | | $85.68 | $111.38 | $196.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.02 / $181.45 / $287.51
| Professional | | $121.02 | $181.45 | $287.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.68 / $201.52 / $403.04
| Professional | | $122.68 | $201.52 | $403.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $168.26 / $6,679.00
| Facility | | $83.43 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.44 / $158.51 / $283.41
| Professional | | $125.44 | $158.51 | $283.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.88 / $204.30 / $339.19
| Professional | | $94.88 | $204.30 | $339.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $579.51 / $886.70 / $1,494.48
| Facility | | $579.51 | $886.70 | $1,494.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.08 / $154.08 / $186.85
| Professional | | $154.08 | $154.08 | $186.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,878.00 / $7,161.00
| Facility | | $55.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.47 / $275.16 / $973.08
| Professional | | $143.47 | $275.16 | $973.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.93 / $171.99 / $366.12
| Professional | | $130.93 | $171.99 | $366.12 |