- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.77 / $2,079.00 / $3,685.00
| Facility | | $71.77 | $2,079.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $93.45 / $267.23
| Professional | | $44.67 | $93.45 | $267.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.73 / $612.10 / $2,713.00
| Facility | | $121.73 | $612.10 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.68 / $136.79 / $408.00
| Professional | | $60.68 | $136.79 | $408.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.41 / $81.13 / $145.16
| Facility | | $62.41 | $81.13 | $145.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.06 / $104.69 / $224.61
| Professional | | $58.06 | $104.69 | $224.61 |
- 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
- $61.48 / $121.75 / $245.74
| Professional | | $61.48 | $121.75 | $245.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.00 / $168.26 / $6,679.00
| Facility | | $64.00 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.17 / $130.80 / $180.56
| Professional | | $104.17 | $130.80 | $180.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.58 / $141.80 / $257.35
| Professional | | $67.58 | $141.80 | $257.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.95 / $332.16 / $3,217.35
| Facility | | $261.95 | $332.16 | $3,217.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.71 / $159.71 / $159.71
| Professional | | $159.71 | $159.71 | $159.71 |
- 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
- $108.55 / $178.87 / $680.48
| Professional | | $108.55 | $178.87 | $680.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $3,445.00
| Facility | | $627.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.08 / $137.24 / $253.37
| Professional | | $97.08 | $137.24 | $253.37 |