- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.00 / $2,618.00 / $4,806.64
| Facility | | $699.00 | $2,618.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.53 / $205.65 / $436.10
| Professional | | $135.53 | $205.65 | $436.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.45 / $2,376.00 / $8,498.00
| Facility | | $438.45 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.28 / $360.14 / $1,325.36
| Professional | | $181.28 | $360.14 | $1,325.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.02 / $282.13 / $497.84
| Facility | | $217.02 | $282.13 | $497.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.10 / $390.75 / $597.99
| Professional | | $274.10 | $390.75 | $597.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.82 / $342.52 / $680.15
| Professional | | $204.82 | $342.52 | $680.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.57 / $395.72 / $6,679.00
| Facility | | $186.57 | $395.72 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.45 / $334.71 / $462.04
| Professional | | $265.45 | $334.71 | $462.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.51 / $473.99 / $734.50
| Professional | | $226.51 | $473.99 | $734.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $897.36 / $1,894.46 / $3,072.75
| Facility | | $897.36 | $1,894.46 | $3,072.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $268.98 / $336.60 / $376.23
| Professional | | $268.98 | $336.60 | $376.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,256.88 / $3,372.00 / $16,394.00
| Facility | | $1,256.88 | $3,372.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.13 / $440.86 / $1,723.76
| Professional | | $254.13 | $440.86 | $1,723.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.03 / $343.59 / $714.33
| Professional | | $208.03 | $343.59 | $714.33 |