- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.00 / $1,746.00 / $7,175.00
| Facility | | $379.00 | $1,746.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.55 / $147.61 / $227.45
| Professional | | $121.55 | $147.61 | $227.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.17 / $179.71 / $179.71
| Professional | | $173.17 | $179.71 | $179.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.88 / $173.15 / $312.64
| Professional | | $131.88 | $173.15 | $312.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.40 / $267.95 / $276.72
| Professional | | $208.40 | $267.95 | $276.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $950.81 / $950.81 / $1,915.72
| Facility | | $950.81 | $950.81 | $1,915.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,326.00 / $8,017.00
| Facility | | $540.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.95 / $160.19 / $768.00
| Professional | | $122.95 | $160.19 | $768.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.38 / $166.90 / $194.66
| Professional | | $140.38 | $166.90 | $194.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.31 / $236.31 / $236.31
| Facility | | $236.31 | $236.31 | $236.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.72 / $178.50 / $325.72
| Professional | | $135.72 | $178.50 | $325.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.62 / $137.12 / $172.22
| Facility | | $130.62 | $137.12 | $172.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.41 / $150.87 / $184.07
| Professional | | $133.41 | $150.87 | $184.07 |
- 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
- $139.88 / $185.68 / $305.02
| Professional | | $139.88 | $185.68 | $305.02 |