- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.22 / $1,886.00 / $3,625.00
| Facility | | $136.22 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.76 / $158.69 / $357.21
| Professional | | $95.76 | $158.69 | $357.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.62 / $781.24 / $2,713.00
| Facility | | $264.62 | $781.24 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.00 / $266.58 / $869.52
| Professional | | $130.00 | $266.58 | $869.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.37 / $182.48 / $322.01
| Facility | | $140.37 | $182.48 | $322.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.90 / $291.51 / $435.31
| Professional | | $182.90 | $291.51 | $435.31 |
- 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
- $136.50 / $241.46 / $507.20
| Professional | | $136.50 | $241.46 | $507.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.18 / $214.32 / $6,679.00
| Facility | | $121.18 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.68 / $253.51 / $349.94
| Professional | | $200.68 | $253.51 | $349.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.63 / $310.44 / $509.21
| Professional | | $146.63 | $310.44 | $509.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.12 / $291.75 / $304.60
| Professional | | $190.12 | $291.75 | $304.60 |
- 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
- $178.10 / $336.14 / $1,306.16
| Professional | | $178.10 | $336.14 | $1,306.16 |
- 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
- $139.04 / $255.09 / $575.96
| Professional | | $139.04 | $255.09 | $575.96 |