- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.49 / $2,079.00 / $3,625.00
| Facility | | $90.49 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.26 / $89.27 / $151.04
| Professional | | $64.26 | $89.27 | $151.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.10 / $536.38 / $2,713.00
| Facility | | $109.10 | $536.38 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.73 / $146.69 / $631.34
| Professional | | $72.73 | $146.69 | $631.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.80 / $101.26 / $180.77
| Facility | | $78.80 | $101.26 | $180.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.68 / $141.96 / $242.03
| Professional | | $102.68 | $141.96 | $242.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.80 / $139.15 / $237.03
| Professional | | $83.80 | $139.15 | $237.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.20 / $168.26 / $6,679.00
| Facility | | $80.20 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.31 / $127.56 / $174.82
| Professional | | $105.31 | $127.56 | $174.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.65 / $182.16 / $280.54
| Professional | | $85.65 | $182.16 | $280.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.59 / $43.59 / $87.19
| Professional | | $43.59 | $43.59 | $87.19 |
- 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
- $95.69 / $184.18 / $669.60
| Professional | | $95.69 | $184.18 | $669.60 |
- 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
- $90.22 / $132.86 / $253.59
| Professional | | $90.22 | $132.86 | $253.59 |