- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.89 / $2,083.00 / $3,685.00
| Facility | | $205.89 | $2,083.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.26 / $293.56 / $649.79
| Professional | | $88.26 | $293.56 | $649.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.95 / $953.00 / $26,542.00
| Facility | | $299.95 | $953.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.07 / $465.63 / $1,952.00
| Professional | | $136.07 | $465.63 | $1,952.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.09 / $189.92 / $372.53
| Facility | | $146.09 | $189.92 | $372.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.82 / $327.86 / $601.10
| Professional | | $204.82 | $327.86 | $601.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.31 / $452.85 / $931.35
| Professional | | $228.31 | $452.85 | $931.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.65 / $300.00 / $6,679.00
| Facility | | $128.65 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.30 / $395.88 / $707.80
| Professional | | $330.30 | $395.88 | $707.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.97 / $355.26 / $744.86
| Professional | | $160.97 | $355.26 | $744.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.55 / $209.55 / $209.55
| Professional | | $209.55 | $209.55 | $209.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $614.17 / $2,028.00 / $26,542.00
| Facility | | $614.17 | $2,028.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.60 / $786.92 / $2,479.14
| Professional | | $431.60 | $786.92 | $2,479.14 |
- 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
- $418.47 / $606.80 / $875.73
| Professional | | $418.47 | $606.80 | $875.73 |