- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.02 / $1,499.00 / $6,012.00
| Facility | | $108.02 | $1,499.00 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.06 / $98.93 / $175.18
| Professional | | $69.06 | $98.93 | $175.18 |
- 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
- $108.46 / $163.72 / $214.02
| Professional | | $108.46 | $163.72 | $214.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.30 / $129.97 / $219.21
| Professional | | $82.30 | $129.97 | $219.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.61 / $168.67 / $171.90
| Professional | | $127.61 | $168.67 | $171.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.37 / $1,830.42 / $2,901.00
| Facility | | $699.37 | $1,830.42 | $2,901.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.94 / $1,681.00 / $7,175.00
| Facility | | $142.94 | $1,681.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.04 / $108.43 / $318.64
| Professional | | $73.04 | $108.43 | $318.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $146.69 / $281.70
| Professional | | $3.00 | $146.69 | $281.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.12 / $130.33 / $220.18
| Professional | | $84.12 | $130.33 | $220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.45 / $84.58 / $161.65
| Facility | | $75.45 | $84.58 | $161.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.45 / $105.09 / $113.97
| Professional | | $75.45 | $105.09 | $113.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $1,305.00 / $3,742.00
| Facility | | $471.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.45 / $138.13 / $233.00
| Professional | | $109.45 | $138.13 | $233.00 |