- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.60 / $2,663.12 / $3,625.00
| Facility | | $120.60 | $2,663.12 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.41 / $120.60 / $273.20
| Professional | | $23.41 | $120.60 | $273.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.04 / $1,588.55 / $16,394.00
| Facility | | $79.04 | $1,588.55 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.89 / $224.32 / $746.78
| Professional | | $34.89 | $224.32 | $746.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.61 / $48.89 / $95.91
| Facility | | $37.61 | $48.89 | $95.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.99 / $87.93 / $309.89
| Professional | | $47.99 | $87.93 | $309.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.60 / $179.45 / $503.78
| Professional | | $58.60 | $179.45 | $503.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.90 / $300.00 / $6,679.00
| Facility | | $38.90 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.94 / $205.26 / $366.99
| Professional | | $173.94 | $205.26 | $366.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.54 / $170.80 / $425.39
| Professional | | $40.54 | $170.80 | $425.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.35 / $264.35 / $264.35
| Professional | | $264.35 | $264.35 | $264.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,430.00 / $16,394.00
| Facility | | $540.00 | $2,430.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.28 / $382.65 / $1,048.33
| Professional | | $216.28 | $382.65 | $1,048.33 |
- 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
- $210.63 / $265.02 / $564.95
| Professional | | $210.63 | $265.02 | $564.95 |