- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.26 / $2,747.00 / $8,104.00
| Facility | | $66.26 | $2,747.00 | $8,104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.78 / $129.83 / $237.34
| Professional | | $58.78 | $129.83 | $237.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.30 / $176.60 / $253.93
| Professional | | $121.30 | $176.60 | $253.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.28 / $136.29 / $252.35
| Professional | | $66.28 | $136.29 | $252.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.95 / $222.91 / $229.01
| Professional | | $167.95 | $222.91 | $229.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,453.25 / $3,549.15 / $4,044.18
| Facility | | $3,453.25 | $3,549.15 | $4,044.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $3,964.00 / $8,247.00
| Facility | | $540.00 | $3,964.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.00 / $137.99 / $342.20
| Professional | | $60.00 | $137.99 | $342.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $105.60 / $397.90
| Professional | | $5.00 | $105.60 | $397.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.34 / $140.21 / $265.88
| Professional | | $69.34 | $140.21 | $265.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.89 / $87.57 / $140.62
| Facility | | $61.89 | $87.57 | $140.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.87 / $134.78 / $152.30
| Professional | | $61.87 | $134.78 | $152.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.93 / $165.88 / $271.06
| Professional | | $110.93 | $165.88 | $271.06 |