- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.00 / $2,070.00 / $7,197.00
| Facility | | $428.00 | $2,070.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.14 / $108.62 / $201.91
| Professional | | $27.14 | $108.62 | $201.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.24 / $162.26 / $261.25
| Professional | | $109.24 | $162.26 | $261.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.00 / $51.00 / $51.00
| Facility | | $51.00 | $51.00 | $51.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.31 / $104.41 / $214.87
| Professional | | $32.31 | $104.41 | $214.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.53 / $176.81 / $228.91
| Professional | | $132.53 | $176.81 | $228.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.75 / $386.04 / $1,363.32
| Facility | | $375.75 | $386.04 | $1,363.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,326.00 / $8,017.00
| Facility | | $641.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.39 / $112.74 / $368.10
| Professional | | $27.39 | $112.74 | $368.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.19 / $143.19 / $264.50
| Professional | | $143.19 | $143.19 | $264.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.00 / $51.00 / $51.00
| Facility | | $51.00 | $51.00 | $51.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.31 / $103.67 / $223.96
| Professional | | $32.31 | $103.67 | $223.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.66 / $29.43 / $116.05
| Facility | | $27.66 | $29.43 | $116.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.41 / $110.68 / $121.82
| Professional | | $28.41 | $110.68 | $121.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.60 / $160.85 / $242.53
| Professional | | $116.60 | $160.85 | $242.53 |