- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.47 / $1,803.00 / $3,625.00
| Facility | | $160.47 | $1,803.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.45 / $94.74 / $249.91
| Professional | | $29.45 | $94.74 | $249.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.33 / $1,483.60 / $7,161.00
| Facility | | $56.33 | $1,483.60 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.40 / $66.06 / $1,928.00
| Professional | | $26.40 | $66.06 | $1,928.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.82 / $35.75 / $63.82
| Facility | | $27.82 | $35.75 | $63.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.75 / $60.11 / $149.69
| Professional | | $37.75 | $60.11 | $149.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.34 / $63.18 / $374.89
| Professional | | $34.34 | $63.18 | $374.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.80 / $296.51 / $6,679.00
| Facility | | $28.80 | $296.51 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.18 / $46.25 / $63.04
| Professional | | $38.18 | $46.25 | $63.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.72 / $65.45 / $102.02
| Professional | | $30.72 | $65.45 | $102.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $908.78 / $932.30 / $2,098.52
| Facility | | $908.78 | $932.30 | $2,098.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.78 / $59.20 / $145.69
| Professional | | $38.78 | $59.20 | $145.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.80 / $2,078.00 / $12,000.00
| Facility | | $308.80 | $2,078.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.01 / $160.53 / $1,928.00
| Professional | | $42.01 | $160.53 | $1,928.00 |
- 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
- $38.56 / $85.71 / $470.71
| Professional | | $38.56 | $85.71 | $470.71 |