- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.83 / $9,639.00 / $20,509.00
| Facility | | $116.83 | $9,639.00 | $20,509.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.78 / $116.83 / $628.63
| Professional | | $103.78 | $116.83 | $628.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,050.00 / $4,401.00 / $9,119.00
| Facility | | $2,050.00 | $4,401.00 | $9,119.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.58 / $211.77 / $407.18
| Professional | | $161.58 | $211.77 | $407.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.50 / $100.00 / $5,485.17
| Facility | | $63.50 | $100.00 | $5,485.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $141.91 / $345.96
| Professional | | $100.00 | $141.91 | $345.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.79 / $156.94 / $439.22
| Professional | | $120.79 | $156.94 | $439.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.36 / $106.49 / $152.60
| Professional | | $70.36 | $106.49 | $152.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.00 / $154.44 / $272.30
| Professional | | $118.00 | $154.44 | $272.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $266.08 / $1,300.00
| Facility | | $55.00 | $266.08 | $1,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $883.32 / $883.32 / $1,123.34
| Professional | | $883.32 | $883.32 | $1,123.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.56 / $153.58 / $225.00
| Facility | | $123.56 | $153.58 | $225.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.67 / $156.94 / $339.91
| Professional | | $120.67 | $156.94 | $339.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.05 / $390.05 / $390.05
| Professional | | $390.05 | $390.05 | $390.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.36 / $115.36 / $140.57
| Professional | | $70.36 | $115.36 | $140.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,009.00 / $5,159.00 / $20,279.00
| Facility | | $2,009.00 | $5,159.00 | $20,279.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.56 / $150.47 / $432.15
| Professional | | $105.56 | $150.47 | $432.15 |