- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.36 / $2,747.00 / $8,113.00
| Facility | | $96.36 | $2,747.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.72 / $149.91 / $714.04
| Professional | | $82.72 | $149.91 | $714.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.10 / $632.94 / $952.71
| Professional | | $385.10 | $632.94 | $952.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.97 / $147.18 / $147.18
| Facility | | $84.97 | $147.18 | $147.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.75 / $197.11 / $954.27
| Professional | | $87.75 | $197.11 | $954.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $687.42 / $1,002.85 / $1,321.38
| Professional | | $687.42 | $1,002.85 | $1,321.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $793.54 / $4,264.00 / $8,247.00
| Facility | | $793.54 | $4,264.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.24 / $198.93 / $793.54
| Professional | | $85.24 | $198.93 | $793.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.82 / $198.90 / $1,149.94
| Professional | | $90.82 | $198.90 | $1,149.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.97 / $147.18 / $195.89
| Facility | | $84.97 | $147.18 | $195.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.84 / $212.53 / $954.27
| Professional | | $89.84 | $212.53 | $954.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.78 / $194.95 / $659.15
| Facility | | $88.78 | $194.95 | $659.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.78 / $194.95 / $672.33
| Professional | | $88.78 | $194.95 | $672.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.46 / $513.55 / $952.08
| Professional | | $181.46 | $513.55 | $952.08 |