- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.54 / $1,473.20 / $3,363.00
| Facility | | $219.54 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.32 / $83.73 / $161.74
| Professional | | $40.32 | $83.73 | $161.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.68 / $536.38 / $2,713.00
| Facility | | $65.68 | $536.38 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.41 / $118.17 / $628.08
| Professional | | $46.41 | $118.17 | $628.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.67 / $59.97 / $119.01
| Facility | | $46.67 | $59.97 | $119.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.55 / $121.39 / $201.20
| Professional | | $59.55 | $121.39 | $201.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.29 / $105.38 / $221.52
| Professional | | $54.29 | $105.38 | $221.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.42 / $85.10 / $8,090.00
| Facility | | $47.42 | $85.10 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.26 / $123.54 / $170.97
| Professional | | $101.26 | $123.54 | $170.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.86 / $113.11 / $258.85
| Professional | | $53.86 | $113.11 | $258.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.33 / $168.42 / $219.31
| Professional | | $159.33 | $168.42 | $219.31 |
- 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
- $81.83 / $173.29 / $628.08
| Professional | | $81.83 | $173.29 | $628.08 |
- 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
- $74.70 / $122.36 / $278.94
| Professional | | $74.70 | $122.36 | $278.94 |