- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.49 / $1,699.00 / $3,363.00
| Facility | | $112.49 | $1,699.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.49 / $208.05 / $526.46
| Professional | | $112.49 | $208.05 | $526.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.35 / $1,588.55 / $12,000.00
| Facility | | $328.35 | $1,588.55 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.49 / $278.08 / $976.24
| Professional | | $124.49 | $278.08 | $976.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.22 / $203.10 / $358.39
| Facility | | $156.22 | $203.10 | $358.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.03 / $286.57 / $418.45
| Professional | | $219.03 | $286.57 | $418.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.90 / $322.79 / $626.24
| Professional | | $233.90 | $322.79 | $626.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.84 / $300.00 / $6,679.00
| Facility | | $135.84 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.76 / $235.41 / $420.89
| Professional | | $193.76 | $235.41 | $420.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.30 / $348.00 / $500.88
| Professional | | $166.30 | $348.00 | $500.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.63 / $937.59 / $1,962.28
| Facility | | $567.63 | $937.59 | $1,962.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.50 / $207.33 / $487.43
| Professional | | $179.50 | $207.33 | $487.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $665.24 / $2,430.00 / $12,000.00
| Facility | | $665.24 | $2,430.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.11 / $413.14 / $1,179.04
| Professional | | $214.11 | $413.14 | $1,179.04 |
- 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
- $201.87 / $263.75 / $478.67
| Professional | | $201.87 | $263.75 | $478.67 |