- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.47 / $2,067.00 / $3,625.00
| Facility | | $138.47 | $2,067.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.95 / $116.07 / $208.62
| Professional | | $60.95 | $116.07 | $208.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.90 / $1,483.60 / $7,161.00
| Facility | | $145.90 | $1,483.60 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.02 / $212.37 / $1,227.00
| Professional | | $71.02 | $212.37 | $1,227.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.36 / $94.27 / $187.43
| Facility | | $73.36 | $94.27 | $187.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.61 / $248.59 / $432.79
| Professional | | $93.61 | $248.59 | $432.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.38 / $168.72 / $355.94
| Professional | | $86.38 | $168.72 | $355.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.47 / $231.43 / $6,679.00
| Facility | | $73.47 | $231.43 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.22 / $225.97 / $312.61
| Professional | | $185.22 | $225.97 | $312.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.96 / $196.20 / $471.47
| Professional | | $86.96 | $196.20 | $471.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.41 / $0.41 / $0.41
| Facility | | $0.41 | $0.41 | $0.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.56 / $102.09 / $283.41
| Professional | | $99.56 | $102.09 | $283.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.41 / $2,078.00 / $12,000.00
| Facility | | $313.41 | $2,078.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.38 / $275.83 / $1,227.00
| Professional | | $159.38 | $275.83 | $1,227.00 |
- 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
- $154.83 / $247.04 / $459.09
| Professional | | $154.83 | $247.04 | $459.09 |