- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.91 / $1,886.00 / $3,625.00
| Facility | | $134.91 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.67 / $153.31 / $465.53
| Professional | | $102.67 | $153.31 | $465.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.97 / $941.10 / $4,142.00
| Facility | | $299.97 | $941.10 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.85 / $256.50 / $902.48
| Professional | | $127.85 | $256.50 | $902.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.36 / $186.37 / $328.87
| Facility | | $143.36 | $186.37 | $328.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.54 / $295.85 / $412.35
| Professional | | $194.54 | $295.85 | $412.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.65 / $271.16 / $539.97
| Professional | | $149.65 | $271.16 | $539.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.95 / $300.00 / $6,679.00
| Facility | | $124.95 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.66 / $230.81 / $318.61
| Professional | | $184.66 | $230.81 | $318.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.78 / $317.29 / $456.36
| Professional | | $152.78 | $317.29 | $456.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.14 / $264.10 / $270.80
| Professional | | $258.14 | $264.10 | $270.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.47 / $1,818.00 / $12,000.00
| Facility | | $611.47 | $1,818.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.89 / $334.86 / $1,212.64
| Professional | | $169.89 | $334.86 | $1,212.64 |
- 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
- $146.76 / $240.34 / $452.81
| Professional | | $146.76 | $240.34 | $452.81 |