- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.50 / $1,803.00 / $3,363.00
| Facility | | $304.50 | $1,803.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.67 / $124.09 / $292.08
| Professional | | $78.67 | $124.09 | $292.08 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $204.82 / $500.77 / $737.28
| Professional | 50 | $204.82 | $500.77 | $737.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.57 / $1,177.70 / $3,472.00
| Facility | | $87.57 | $1,177.70 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.30 / $163.58 / $1,367.00
| Professional | | $61.30 | $163.58 | $1,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.65 / $80.51 / $159.76
| Facility | | $62.65 | $80.51 | $159.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.02 / $167.63 / $339.13
| Professional | | $85.02 | $167.63 | $339.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.34 / $158.88 / $294.97
| Professional | | $77.34 | $158.88 | $294.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.86 / $300.00 / $6,679.00
| Facility | | $63.86 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.56 / $154.28 / $212.96
| Professional | | $126.56 | $154.28 | $212.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.09 / $148.21 / $322.83
| Professional | | $70.09 | $148.21 | $322.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.24 / $156.84 / $4,320.53
| Facility | | $137.24 | $156.84 | $4,320.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.67 / $87.04 / $111.00
| Professional | | $65.67 | $87.04 | $111.00 |
- 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
- $130.59 / $216.71 / $1,367.00
| Professional | | $130.59 | $216.71 | $1,367.00 |
- 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
- $129.83 / $181.61 / $334.22
| Professional | | $129.83 | $181.61 | $334.22 |