- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.63 / $2,747.00 / $8,017.00
| Facility | | $218.63 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.18 / $204.61 / $348.02
| Professional | | $133.18 | $204.61 | $348.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.40 / $240.13 / $240.13
| Professional | | $231.40 | $240.13 | $240.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.60 / $225.58 / $372.02
| Professional | | $141.60 | $225.58 | $372.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.00 / $278.79 / $369.56
| Professional | | $96.00 | $278.79 | $369.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,890.97 / $1,890.97 / $3,498.65
| Facility | | $1,890.97 | $1,890.97 | $3,498.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.61 / $227.41 / $227.41
| Professional | | $217.61 | $227.41 | $227.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,679.00 / $8,017.00
| Facility | | $594.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.87 / $218.62 / $414.64
| Professional | | $134.87 | $218.62 | $414.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.04 / $241.60 / $332.86
| Professional | | $146.04 | $241.60 | $332.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.81 / $261.81 / $261.81
| Facility | | $261.81 | $261.81 | $261.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.04 / $229.22 / $424.98
| Professional | | $146.04 | $229.22 | $424.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.75 / $155.96 / $229.79
| Facility | | $150.75 | $155.96 | $229.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.63 / $208.38 / $246.57
| Professional | | $150.63 | $208.38 | $246.57 |
- 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
- $198.46 / $246.15 / $428.31
| Professional | | $198.46 | $246.15 | $428.31 |