- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.66 / $1,695.05 / $5,878.51
| Facility | | $161.66 | $1,695.05 | $5,878.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.30 / $152.93 / $446.08
| Professional | | $98.30 | $152.93 | $446.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.74 / $124.74 / $124.74
| Professional | | $124.74 | $124.74 | $124.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.09 / $175.47 / $300.16
| Professional | | $169.09 | $175.47 | $300.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.10 / $168.40 / $299.49
| Professional | | $121.10 | $168.40 | $299.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.00 / $203.68 / $269.85
| Professional | | $24.00 | $203.68 | $269.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.14 / $2,048.07 / $3,373.69
| Facility | | $801.14 | $2,048.07 | $3,373.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.62 / $169.69 / $174.24
| Professional | | $148.62 | $169.69 | $174.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.35 / $2,328.03 / $7,175.00
| Facility | | $188.35 | $2,328.03 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.76 / $163.38 / $396.97
| Professional | | $113.76 | $163.38 | $396.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.99 / $178.80 / $243.85
| Professional | | $124.99 | $178.80 | $243.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.46 / $222.46 / $222.46
| Facility | | $222.46 | $222.46 | $222.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.18 / $170.48 / $307.33
| Professional | | $123.18 | $170.48 | $307.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.42 / $128.82 / $168.66
| Facility | | $116.42 | $128.82 | $168.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.06 / $148.44 / $181.15
| Professional | | $126.06 | $148.44 | $181.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.00 / $1,219.00 / $4,300.00
| Facility | | $412.00 | $1,219.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.75 / $184.93 / $332.01
| Professional | | $140.75 | $184.93 | $332.01 |