- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.44 / $2,079.00 / $3,625.00
| Facility | | $161.44 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.73 / $189.80 / $624.28
| Professional | | $67.73 | $189.80 | $624.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.34 / $1,339.09 / $3,804.00
| Facility | | $191.34 | $1,339.09 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.38 / $437.70 / $2,397.36
| Professional | | $95.38 | $437.70 | $2,397.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.58 / $128.15 / $251.38
| Facility | | $98.58 | $128.15 | $251.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.86 / $356.63 / $580.41
| Professional | | $141.86 | $356.63 | $580.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.69 / $349.10 / $820.38
| Professional | | $136.69 | $349.10 | $820.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.88 / $179.74 / $6,679.00
| Facility | | $86.88 | $179.74 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.52 / $335.52 / $599.88
| Professional | | $265.52 | $335.52 | $599.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.58 / $281.39 / $624.74
| Professional | | $109.58 | $281.39 | $624.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.81 / $140.24 / $270.92
| Professional | | $136.81 | $140.24 | $270.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,878.00 / $7,161.00
| Facility | | $55.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.69 / $912.48 / $2,506.13
| Professional | | $305.69 | $912.48 | $2,506.13 |
- 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
- $263.64 / $538.59 / $995.31
| Professional | | $263.64 | $538.59 | $995.31 |