- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.70 / $1,486.00 / $3,398.55
| Facility | | $64.70 | $1,486.00 | $3,398.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.76 / $91.14 / $196.19
| Professional | | $41.76 | $91.14 | $196.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.81 / $586.61 / $2,713.00
| Facility | | $72.81 | $586.61 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.97 / $152.16 / $384.99
| Professional | | $50.97 | $152.16 | $384.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.16 / $67.03 / $133.01
| Facility | | $52.16 | $67.03 | $133.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.12 / $126.20 / $246.08
| Professional | | $62.12 | $126.20 | $246.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.15 / $123.92 / $255.47
| Professional | | $61.15 | $123.92 | $255.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.41 / $300.00 / $6,679.00
| Facility | | $53.41 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.85 / $128.75 / $177.72
| Professional | | $105.85 | $128.75 | $177.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.93 / $124.59 / $270.67
| Professional | | $58.93 | $124.59 | $270.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.46 / $349.27 / $436.74
| Facility | | $342.46 | $349.27 | $436.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.15 / $148.83 / $167.09
| Professional | | $75.15 | $148.83 | $167.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.86 / $236.02 / $888.72
| Professional | | $121.86 | $236.02 | $888.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.64 / $206.59 / $362.01
| Professional | | $112.64 | $206.59 | $362.01 |