- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.22 / $1,030.00 / $2,900.00
| Facility | | $156.22 | $1,030.00 | $2,900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.48 / $179.37 / $450.03
| Professional | | $100.48 | $179.37 | $450.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.99 / $947.00 / $2,713.00
| Facility | | $247.99 | $947.00 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.76 / $274.57 / $978.00
| Professional | | $120.76 | $274.57 | $978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.25 / $168.03 / $296.50
| Facility | | $129.25 | $168.03 | $296.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.39 / $281.20 / $465.08
| Professional | | $175.39 | $281.20 | $465.08 |
- 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
- $147.44 / $266.13 / $595.07
| Professional | | $147.44 | $266.13 | $595.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.58 / $214.32 / $6,679.00
| Facility | | $111.58 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.44 / $260.29 / $359.36
| Professional | | $205.44 | $260.29 | $359.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.16 / $283.63 / $504.89
| Professional | | $135.16 | $283.63 | $504.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $274.38 / $571.54
| Facility | | $144.54 | $274.38 | $571.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.70 / $354.74 / $1,331.92
| Professional | | $193.70 | $354.74 | $1,331.92 |
- 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
- $168.58 / $273.50 / $506.90
| Professional | | $168.58 | $273.50 | $506.90 |