- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.14 / $1,886.00 / $3,625.00
| Facility | | $208.14 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.59 / $208.14 / $569.48
| Professional | | $74.59 | $208.14 | $569.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.25 / $720.06 / $7,231.00
| Facility | | $232.25 | $720.06 | $7,231.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.98 / $480.91 / $2,470.80
| Professional | | $121.98 | $480.91 | $2,470.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.77 / $157.00 / $307.95
| Facility | | $120.77 | $157.00 | $307.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.21 / $541.79 / $944.74
| Professional | | $165.21 | $541.79 | $944.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.72 / $461.00 / $1,016.75
| Professional | | $164.72 | $461.00 | $1,016.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.66 / $300.00 / $6,679.00
| Facility | | $105.66 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.23 / $507.01 / $744.78
| Professional | | $401.23 | $507.01 | $744.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.93 / $354.91 / $939.94
| Professional | | $133.93 | $354.91 | $939.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.72 / $332.72 / $332.72
| Facility | | $332.72 | $332.72 | $332.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $2,028.00 / $12,000.00
| Facility | | $627.00 | $2,028.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.20 / $865.00 / $2,470.80
| Professional | | $326.20 | $865.00 | $2,470.80 |
- 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
- $290.63 / $480.91 / $1,073.46
| Professional | | $290.63 | $480.91 | $1,073.46 |