- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.66 / $988.00 / $2,900.00
| Facility | | $87.66 | $988.00 | $2,900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.27 / $114.70 / $283.87
| Professional | | $53.27 | $114.70 | $283.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.06 / $3,110.00 / $7,608.00
| Facility | | $136.06 | $3,110.00 | $7,608.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.37 / $180.06 / $1,265.00
| Professional | | $68.37 | $180.06 | $1,265.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.81 / $94.67 / $185.69
| Facility | | $72.81 | $94.67 | $185.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.42 / $119.42 / $255.22
| Professional | | $119.42 | $119.42 | $255.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.30 / $198.74 / $411.75
| Professional | | $92.30 | $198.74 | $411.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.09 / $300.00 / $6,679.00
| Facility | | $73.09 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.28 / $186.11 / $332.75
| Professional | | $147.28 | $186.11 | $332.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.67 / $167.85 / $345.56
| Professional | | $77.67 | $167.85 | $345.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.43 / $0.43 / $1,384.94
| Facility | | $0.43 | $0.43 | $1,384.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.34 / $187.00 / $211.47
| Professional | | $174.34 | $187.00 | $211.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $4,287.00 / $9,401.00
| Facility | | $55.00 | $4,287.00 | $9,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.90 / $281.47 / $1,265.00
| Professional | | $144.90 | $281.47 | $1,265.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.44 / $204.36 / $455.95
| Professional | | $122.44 | $204.36 | $455.95 |