- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.44 / $3,069.00 / $8,113.00
| Facility | | $140.44 | $3,069.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.65 / $140.44 / $261.39
| Professional | | $117.65 | $140.44 | $261.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.77 / $323.52 / $530.42
| Professional | | $311.77 | $323.52 | $530.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.74 / $135.72 / $233.69
| Professional | | $96.74 | $135.72 | $233.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.62 / $116.62 / $150.38
| Professional | | $116.62 | $116.62 | $150.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.96 / $155.96 / $155.96
| Professional | | $155.96 | $155.96 | $155.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,264.00 / $8,247.00
| Facility | | $832.00 | $4,264.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.31 / $156.60 / $1,544.00
| Professional | | $124.31 | $156.60 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.00 / $25.00 / $25.00
| Professional | | $25.00 | $25.00 | $25.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.18 / $129.83 / $196.85
| Professional | | $96.18 | $129.83 | $196.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.00 / $304.83 / $304.83
| Facility | | $294.00 | $304.83 | $304.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.78 / $298.54 / $304.83
| Professional | | $92.78 | $298.54 | $304.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.31 / $294.12 / $565.60
| Professional | | $66.31 | $294.12 | $565.60 |