- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $1,803.00 / $3,381.30
| Facility | | $659.00 | $1,803.00 | $3,381.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.38 / $163.58 / $348.33
| Professional | | $67.38 | $163.58 | $348.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.18 / $1,878.00 / $7,161.00
| Facility | | $203.18 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.23 / $336.42 / $1,637.60
| Professional | | $109.23 | $336.42 | $1,637.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.20 / $127.47 / $252.96
| Facility | | $99.20 | $127.47 | $252.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.02 / $236.29 / $498.96
| Professional | | $113.02 | $236.29 | $498.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.06 / $237.50 / $572.42
| Professional | | $111.06 | $237.50 | $572.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.87 / $300.00 / $6,679.00
| Facility | | $86.87 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.52 / $321.51 / $446.07
| Professional | | $263.52 | $321.51 | $446.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.70 / $278.52 / $661.58
| Professional | | $116.70 | $278.52 | $661.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,307.29 / $1,859.98 / $2,618.26
| Facility | | $1,307.29 | $1,859.98 | $2,618.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.58 / $123.80 / $136.29
| Professional | | $62.58 | $123.80 | $136.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.22 / $2,078.00 / $12,000.00
| Facility | | $424.22 | $2,078.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.07 / $497.32 / $1,637.60
| Professional | | $254.07 | $497.32 | $1,637.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.37 / $352.80 / $704.90
| Professional | | $248.37 | $352.80 | $704.90 |