- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.71 / $1,746.00 / $7,197.00
| Facility | | $88.71 | $1,746.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.22 / $112.23 / $197.30
| Professional | | $53.22 | $112.23 | $197.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $4,354.00 / $8,459.92
| Facility | | $1,350.00 | $4,354.00 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.40 / $156.05 / $231.60
| Professional | | $108.40 | $156.05 | $231.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.15 / $119.89 / $220.00
| Professional | | $64.15 | $119.89 | $220.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.24 / $197.81 / $203.93
| Professional | | $149.24 | $197.81 | $203.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.61 / $5,810.35 / $10,877.46
| Facility | | $391.61 | $5,810.35 | $10,877.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.67 / $1,978.00 / $8,017.00
| Facility | | $120.67 | $1,978.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.09 / $117.97 / $315.00
| Professional | | $56.09 | $117.97 | $315.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $108.10 / $350.40
| Professional | | $4.00 | $108.10 | $350.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.95 / $120.55 / $233.48
| Professional | | $65.95 | $120.55 | $233.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.75 / $77.34 / $123.88
| Facility | | $58.75 | $77.34 | $123.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.68 / $118.73 / $133.86
| Professional | | $58.68 | $118.73 | $133.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,000.00
| Facility | | $2,155.00 | $3,475.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.33 / $152.65 / $246.91
| Professional | | $105.33 | $152.65 | $246.91 |