- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.85 / $244.26 / $11,988.53
| Facility | | $132.85 | $244.26 | $11,988.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.73 / $425.00 / $1,429.40
| Professional | | $96.73 | $425.00 | $1,429.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.99 / $415.10 / $2,600.00
| Facility | | $138.99 | $415.10 | $2,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.61 / $253.96 / $1,257.00
| Professional | | $131.61 | $253.96 | $1,257.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.95 / $172.40 / $312.17
| Facility | | $98.95 | $172.40 | $312.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.47 / $192.63 / $203.27
| Professional | | $117.47 | $192.63 | $203.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.48 / $866.41 / $2,047.12
| Facility | | $73.48 | $866.41 | $2,047.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.43 / $175.18 / $432.96
| Professional | | $105.43 | $175.18 | $432.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.50 / $105.96 / $154.66
| Professional | | $25.50 | $105.96 | $154.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.55 / $219.05 / $849.95
| Professional | | $139.55 | $219.05 | $849.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,197.92 / $11,197.92 / $11,197.92
| Facility | | $11,197.92 | $11,197.92 | $11,197.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $850.00 / $850.00 / $850.00
| Professional | | $850.00 | $850.00 | $850.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.88 / $2,600.00 / $2,600.00
| Facility | | $202.88 | $2,600.00 | $2,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,257.00 / $1,257.00 / $1,257.00
| Professional | | $1,257.00 | $1,257.00 | $1,257.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.31 / $176.31 / $176.31
| Professional | | $176.31 | $176.31 | $176.31 |