- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,675.00 / $8,017.00
| Facility | | $540.00 | $2,675.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.14 / $29.23 / $51.34
| Professional | | $22.14 | $29.23 | $51.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.72 / $32.90 / $64.25
| Professional | | $31.72 | $32.90 | $64.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.73 / $41.73 / $41.73
| Facility | | $41.73 | $41.73 | $41.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.58 / $38.27 / $63.68
| Professional | | $24.58 | $38.27 | $63.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.04 / $49.18 / $63.99
| Professional | | $37.04 | $49.18 | $63.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,331.35 / $1,331.35 / $2,470.13
| Facility | | $1,331.35 | $1,331.35 | $2,470.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $2,679.00 / $8,017.00
| Facility | | $934.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.19 / $36.84 / $132.16
| Professional | | $23.19 | $36.84 | $132.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.70 / $67.50 / $88.80
| Professional | | $64.70 | $67.50 | $88.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.73 / $41.73 / $41.73
| Facility | | $41.73 | $41.73 | $41.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.81 / $38.27 / $66.16
| Professional | | $24.81 | $38.27 | $66.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.12 / $31.07 / $53.35
| Facility | | $24.12 | $31.07 | $53.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.12 / $31.07 / $53.35
| Professional | | $24.12 | $31.07 | $53.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.76 / $45.15 / $65.58
| Professional | | $31.76 | $45.15 | $65.58 |