- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.47 / $494.00 / $2,900.00
| Facility | | $110.47 | $494.00 | $2,900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.45 / $111.87 / $242.03
| Professional | | $64.45 | $111.87 | $242.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.83 / $502.00 / $3,445.00
| Facility | | $190.83 | $502.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.81 / $143.09 / $563.44
| Professional | | $70.81 | $143.09 | $563.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.58 / $121.65 / $214.67
| Facility | | $93.58 | $121.65 | $214.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.12 / $162.78 / $234.92
| Professional | | $113.12 | $162.78 | $234.92 |
- 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
- $84.50 / $136.32 / $295.98
| Professional | | $84.50 | $136.32 | $295.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.67 / $204.47 / $6,679.00
| Facility | | $79.67 | $204.47 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.76 / $131.46 / $181.51
| Professional | | $103.76 | $131.46 | $181.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.44 / $195.08 / $270.54
| Professional | | $95.44 | $195.08 | $270.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.09 / $276.58 / $317.66
| Facility | | $130.09 | $276.58 | $317.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.49 / $152.01 / $242.86
| Professional | | $115.49 | $152.01 | $242.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.09 / $1,818.00 / $11,500.00
| Facility | | $402.09 | $1,818.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.95 / $169.65 / $673.20
| Professional | | $90.95 | $169.65 | $673.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.03 / $123.72 / $255.74
| Professional | | $78.03 | $123.72 | $255.74 |