- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.34 / $2,020.00 / $6,762.00
| Facility | | $141.34 | $2,020.00 | $6,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.54 / $123.52 / $218.73
| Professional | | $66.54 | $123.52 | $218.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.07 / $501.63 / $1,083.14
| Facility | | $214.07 | $501.63 | $1,083.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.34 / $145.47 / $218.12
| Professional | | $84.34 | $145.47 | $218.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.16 / $140.16 / $140.16
| Professional | | $140.16 | $140.16 | $140.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.95 / $89.52 / $154.38
| Facility | | $86.95 | $89.52 | $154.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.72 / $155.94 / $243.47
| Professional | | $93.72 | $155.94 | $243.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $481.08
| Facility | | $55.00 | $55.00 | $481.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $686.16 / $1,191.92 / $1,379.40
| Professional | | $686.16 | $1,191.92 | $1,379.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.70 / $128.38 / $218.75
| Facility | | $74.70 | $128.38 | $218.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.03 / $182.44 / $297.20
| Professional | | $114.03 | $182.44 | $297.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.26 / $167.16 / $227.43
| Professional | | $97.26 | $167.16 | $227.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.70 / $128.38 / $218.75
| Facility | | $74.70 | $128.38 | $218.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.85 / $168.92 / $281.43
| Professional | | $95.85 | $168.92 | $281.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $952.00 / $2,405.00
| Facility | | $161.00 | $952.00 | $2,405.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.36 / $169.77 / $247.28
| Professional | | $129.36 | $169.77 | $247.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.38 / $153.13 / $214.40
| Professional | | $136.38 | $153.13 | $214.40 |