- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.91 / $2,266.00 / $8,017.00
| Facility | | $232.91 | $2,266.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.99 / $187.37 / $307.02
| Professional | | $92.99 | $187.37 | $307.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.86 / $186.75 / $186.75
| Professional | | $129.86 | $186.75 | $186.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.37 / $189.13 / $385.42
| Professional | | $100.37 | $189.13 | $385.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.16 / $283.16 / $292.06
| Professional | | $283.16 | $283.16 | $292.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,596.70 / $1,596.70 / $4,698.89
| Facility | | $1,596.70 | $1,596.70 | $4,698.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $2,371.00 / $8,017.00
| Facility | | $594.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.99 / $205.52 / $700.00
| Professional | | $92.99 | $205.52 | $700.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.20 / $186.51 / $480.50
| Professional | | $79.20 | $186.51 | $480.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.37 / $194.89 / $373.87
| Professional | | $100.37 | $194.89 | $373.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.95 / $183.81 / $514.26
| Facility | | $82.95 | $183.81 | $514.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.95 / $180.65 / $229.59
| Professional | | $82.95 | $180.65 | $229.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.00 / $1,305.00 / $3,742.00
| Facility | | $435.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.23 / $293.74 / $404.84
| Professional | | $178.23 | $293.74 | $404.84 |