- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.94 / $1,418.00 / $3,363.00
| Facility | | $140.94 | $1,418.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.36 / $154.34 / $485.58
| Professional | | $82.36 | $154.34 | $485.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.22 / $1,251.81 / $3,472.00
| Facility | | $237.22 | $1,251.81 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.40 / $296.01 / $926.27
| Professional | | $118.40 | $296.01 | $926.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.62 / $164.61 / $322.88
| Facility | | $126.62 | $164.61 | $322.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.82 / $323.54 / $631.61
| Professional | | $171.82 | $323.54 | $631.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.60 / $315.27 / $667.01
| Professional | | $132.60 | $315.27 | $667.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.15 / $214.32 / $6,679.00
| Facility | | $108.15 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.68 / $349.27 / $488.01
| Professional | | $275.68 | $349.27 | $488.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.66 / $301.88 / $668.83
| Professional | | $130.66 | $301.88 | $668.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.67 / $309.66 / $571.54
| Facility | | $167.67 | $309.66 | $571.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,600.00 / $7,161.00
| Facility | | $55.00 | $1,600.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.59 / $404.58 / $1,760.40
| Professional | | $189.59 | $404.58 | $1,760.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.72 / $295.67 / $631.34
| Professional | | $167.72 | $295.67 | $631.34 |