- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.91 / $2,079.00 / $3,625.00
| Facility | | $93.91 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.95 / $103.11 / $204.27
| Professional | | $69.95 | $103.11 | $204.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.63 / $502.00 / $2,713.00
| Facility | | $132.63 | $502.00 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.42 / $185.69 / $570.48
| Professional | | $88.42 | $185.69 | $570.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.78 / $121.79 / $217.43
| Facility | | $94.78 | $121.79 | $217.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.62 / $189.18 / $288.33
| Professional | | $128.62 | $189.18 | $288.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.71 / $170.12 / $307.31
| Professional | | $100.71 | $170.12 | $307.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.95 / $172.82 / $8,090.00
| Facility | | $80.95 | $172.82 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.13 / $167.31 / $231.81
| Professional | | $137.13 | $167.31 | $231.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.78 / $216.12 / $339.87
| Professional | | $102.78 | $216.12 | $339.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,421.38 / $5,421.38 / $5,421.38
| Facility | | $5,421.38 | $5,421.38 | $5,421.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.00 / $176.57 / $199.25
| Professional | | $151.00 | $176.57 | $199.25 |
- 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
- $123.20 / $212.14 / $849.68
| Professional | | $123.20 | $212.14 | $849.68 |
- 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
- $117.42 / $173.39 / $355.10
| Professional | | $117.42 | $173.39 | $355.10 |