- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.96 / $2,747.00 / $8,104.00
| Facility | | $111.96 | $2,747.00 | $8,104.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.46 / $81.59 / $395.00
| Professional | | $15.46 | $81.59 | $395.00 |
- 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
- $94.85 / $98.43 / $98.43
| Professional | | $94.85 | $98.43 | $98.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.09 / $88.09 / $90.08
| Professional | | $88.09 | $88.09 | $90.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.99 / $150.41 / $155.29
| Professional | | $116.99 | $150.41 | $155.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.66 / $3,964.00 / $8,247.00
| Facility | | $366.66 | $3,964.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.46 / $89.77 / $432.00
| Professional | | $15.46 | $89.77 | $432.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.56 / $102.80 / $110.20
| Professional | | $14.56 | $102.80 | $110.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.43 / $19.43 / $19.43
| Facility | | $19.43 | $19.43 | $19.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.09 / $88.09 / $98.90
| Professional | | $88.09 | $88.09 | $98.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.56 / $23.46 / $118.26
| Facility | | $14.56 | $23.46 | $118.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.56 / $72.14 / $129.29
| Professional | | $14.56 | $72.14 | $129.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.74 / $108.38 / $193.30
| Professional | | $85.74 | $108.38 | $193.30 |