- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.66 / $1,886.00 / $3,625.00
| Facility | | $158.66 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.51 / $122.93 / $213.25
| Professional | | $64.51 | $122.93 | $213.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $326.91 / $326.91 / $326.91
| Professional | 50 | $326.91 | $326.91 | $326.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.29 / $1,177.70 / $3,472.00
| Facility | | $88.29 | $1,177.70 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.80 / $146.76 / $1,157.00
| Professional | | $61.80 | $146.76 | $1,157.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.05 / $81.02 / $144.63
| Facility | | $63.05 | $81.02 | $144.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.56 / $156.24 / $350.49
| Professional | | $85.56 | $156.24 | $350.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.16 / $135.00 / $244.98
| Professional | | $74.16 | $135.00 | $244.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.61 / $240.35 / $6,679.00
| Facility | | $64.61 | $240.35 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.52 / $119.35 / $163.87
| Professional | | $98.52 | $119.35 | $163.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.39 / $150.11 / $263.20
| Professional | | $71.39 | $150.11 | $263.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.32 / $280.32 / $280.32
| Facility | | $280.32 | $280.32 | $280.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.65 / $82.65 / $157.66
| Professional | | $82.65 | $82.65 | $157.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,600.00 / $7,161.00
| Facility | | $55.00 | $1,600.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.81 / $221.51 / $1,157.00
| Professional | | $104.81 | $221.51 | $1,157.00 |
- 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
- $97.03 / $186.98 / $287.57
| Professional | | $97.03 | $186.98 | $287.57 |