- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.44 / $2,747.00 / $8,113.00
| Facility | | $93.44 | $2,747.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.58 / $119.92 / $176.68
| Professional | | $88.58 | $119.92 | $176.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.06 / $149.50 / $243.74
| Professional | | $144.06 | $149.50 | $243.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.29 / $135.91 / $235.68
| Professional | | $93.29 | $135.91 | $235.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.28 / $222.79 / $230.29
| Professional | | $173.28 | $222.79 | $230.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,247.00
| Facility | | $657.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.30 / $125.60 / $546.51
| Professional | | $89.30 | $125.60 | $546.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.70 / $166.70 / $175.90
| Professional | | $166.70 | $166.70 | $175.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.72 / $172.72 / $172.72
| Facility | | $172.72 | $172.72 | $172.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.42 / $138.93 / $255.64
| Professional | | $93.42 | $138.93 | $255.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.68 / $111.61 / $147.94
| Facility | | $99.68 | $111.61 | $147.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.68 / $136.88 / $149.72
| Professional | | $99.68 | $136.88 | $149.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.75 / $150.94 / $269.20
| Professional | | $120.75 | $150.94 | $269.20 |