- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.01 / $345.74 / $6,012.00
| Facility | | $61.01 | $345.74 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.51 / $54.97 / $97.66
| Professional | | $39.51 | $54.97 | $97.66 |
- 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
- $59.30 / $61.53 / $106.41
| Professional | | $59.30 | $61.53 | $106.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.03 / $55.25 / $98.35
| Professional | | $37.03 | $55.25 | $98.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.45 / $72.45 / $93.43
| Professional | | $72.45 | $72.45 | $93.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.26 / $310.02 / $416.75
| Facility | | $217.26 | $310.02 | $416.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.66 / $57.05 / $81.03
| Professional | | $55.66 | $57.05 | $81.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.84 / $587.70 / $8,017.00
| Facility | | $65.84 | $587.70 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.93 / $58.86 / $216.78
| Professional | | $39.93 | $58.86 | $216.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.04 / $266.70 / $266.70
| Professional | | $90.04 | $266.70 | $266.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.85 / $55.04 / $92.05
| Professional | | $36.85 | $55.04 | $92.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.40 / $58.43 / $897.45
| Facility | | $40.40 | $58.43 | $897.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.40 / $58.43 / $312.70
| Professional | | $40.40 | $58.43 | $312.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.00 / $650.00 / $3,742.00
| Facility | | $133.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.44 / $68.06 / $119.63
| Professional | | $50.44 | $68.06 | $119.63 |