- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.62 / $2,371.00 / $7,197.00
| Facility | | $93.62 | $2,371.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.54 / $84.55 / $109.95
| Professional | | $69.54 | $84.55 | $109.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.36 / $86.50 / $157.56
| Professional | | $83.36 | $86.50 | $157.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.00 / $358.00 / $358.00
| Facility | | $358.00 | $358.00 | $358.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.59 / $84.39 / $140.66
| Professional | | $59.59 | $84.39 | $140.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.63 / $99.63 / $128.47
| Professional | | $99.63 | $99.63 | $128.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,422.00 / $8,017.00
| Facility | | $594.00 | $2,422.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.25 / $91.14 / $1,234.00
| Professional | | $70.25 | $91.14 | $1,234.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.80 / $81.80 / $120.03
| Professional | | $81.80 | $81.80 | $120.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.00 / $358.00 / $358.00
| Facility | | $358.00 | $358.00 | $358.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.59 / $84.30 / $136.79
| Professional | | $59.59 | $84.30 | $136.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.93 / $70.09 / $83.53
| Facility | | $69.93 | $70.09 | $83.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.86 / $77.23 / $88.44
| Professional | | $69.86 | $77.23 | $88.44 |
- 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
- $69.14 / $90.53 / $158.26
| Professional | | $69.14 | $90.53 | $158.26 |