- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.31 / $90.47 / $1,000.17
| Facility | | $70.31 | $90.47 | $1,000.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.81 / $97.64 / $186.13
| Professional | | $74.81 | $97.64 | $186.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.24 / $73.83 / $129.47
| Professional | | $44.24 | $73.83 | $129.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.64 / $99.64 / $111.75
| Facility | | $99.64 | $99.64 | $111.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.68 / $413.73 / $2,082.57
| Facility | | $184.68 | $413.73 | $2,082.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.73 / $125.09 / $284.23
| Professional | | $80.73 | $125.09 | $284.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.59 / $734.94 / $734.94
| Facility | | $343.59 | $734.94 | $734.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,021.00 / $1,021.00 / $1,021.00
| Professional | | $1,021.00 | $1,021.00 | $1,021.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.30 / $113.99 / $215.64
| Facility | | $84.30 | $113.99 | $215.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.60 / $172.39 / $417.92
| Professional | | $130.60 | $172.39 | $417.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.90 / $455.40 / $548.79
| Professional | | $118.90 | $455.40 | $548.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.42 / $121.44 / $323.83
| Facility | | $84.42 | $121.44 | $323.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.94 / $141.15 / $314.70
| Professional | | $87.94 | $141.15 | $314.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.62 / $855.16 / $1,242.08
| Facility | | $541.62 | $855.16 | $1,242.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.98 / $121.75 / $209.13
| Professional | | $97.98 | $121.75 | $209.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.17 / $99.96 / $141.82
| Professional | | $89.17 | $99.96 | $141.82 |