- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.24 / $2,079.00 / $3,625.00
| Facility | | $116.24 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.93 / $136.33 / $346.05
| Professional | | $76.93 | $136.33 | $346.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.20 / $627.00 / $2,713.00
| Facility | | $214.20 | $627.00 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.77 / $217.03 / $706.24
| Professional | | $105.77 | $217.03 | $706.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.76 / $149.19 / $263.26
| Facility | | $114.76 | $149.19 | $263.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.43 / $230.76 / $364.69
| Professional | | $146.43 | $230.76 | $364.69 |
- 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
- $111.06 / $198.96 / $407.97
| Professional | | $111.06 | $198.96 | $407.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.83 / $209.24 / $6,679.00
| Facility | | $98.83 | $209.24 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.74 / $212.38 / $293.16
| Professional | | $167.74 | $212.38 | $293.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.60 / $253.19 / $410.09
| Professional | | $119.60 | $253.19 | $410.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.23 / $110.00 / $249.51
| Professional | | $107.23 | $110.00 | $249.51 |
- 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
- $149.74 / $285.58 / $1,088.00
| Professional | | $149.74 | $285.58 | $1,088.00 |
- 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
- $136.41 / $207.42 / $394.50
| Professional | | $136.41 | $207.42 | $394.50 |