- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.58 / $2,079.00 / $3,625.00
| Facility | | $134.58 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.14 / $106.73 / $288.06
| Professional | | $27.14 | $106.73 | $288.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $627.00 / $2,733.00
| Facility | | $55.00 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.40 / $185.61 / $498.37
| Professional | | $33.40 | $185.61 | $498.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.75 / $43.37 / $86.23
| Facility | | $33.75 | $43.37 | $86.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.45 / $130.16 / $251.14
| Professional | | $38.45 | $130.16 | $251.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.39 / $127.11 / $314.87
| Professional | | $40.39 | $127.11 | $314.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.61 / $83.43 / $8,090.00
| Facility | | $34.61 | $83.43 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.84 / $160.85 / $224.51
| Professional | | $131.84 | $160.85 | $224.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.10 / $137.46 / $333.66
| Professional | | $40.10 | $137.46 | $333.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.82 / $153.11 / $215.68
| Professional | | $38.82 | $153.11 | $215.68 |
- 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
- $150.28 / $264.51 / $852.84
| Professional | | $150.28 | $264.51 | $852.84 |
- 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
- $148.99 / $221.13 / $490.72
| Professional | | $148.99 | $221.13 | $490.72 |