- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.19 / $2,067.00 / $3,625.00
| Facility | | $156.19 | $2,067.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.25 / $182.30 / $349.97
| Professional | | $111.25 | $182.30 | $349.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.01 / $781.24 / $2,713.00
| Facility | | $305.01 | $781.24 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.57 / $306.12 / $1,001.44
| Professional | | $149.57 | $306.12 | $1,001.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.22 / $209.59 / $369.84
| Facility | | $161.22 | $209.59 | $369.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.62 / $314.12 / $496.43
| Professional | | $203.62 | $314.12 | $496.43 |
- 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
- $157.04 / $278.13 / $586.66
| Professional | | $157.04 | $278.13 | $586.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.35 / $220.47 / $6,679.00
| Facility | | $139.35 | $220.47 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $289.11 / $399.08
| Professional | | $229.09 | $289.11 | $399.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.76 / $357.26 / $561.97
| Professional | | $168.76 | $357.26 | $561.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.87 / $275.97 / $295.18
| Professional | | $181.87 | $275.97 | $295.18 |
- 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
- $206.77 / $384.93 / $1,492.88
| Professional | | $206.77 | $384.93 | $1,492.88 |
- 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
- $188.50 / $304.25 / $620.21
| Professional | | $188.50 | $304.25 | $620.21 |