- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.72 / $2,747.00 / $4,806.64
| Facility | | $138.72 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.72 / $206.50 / $343.85
| Professional | | $138.72 | $206.50 | $343.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.14 / $1,251.81 / $3,804.00
| Facility | | $272.14 | $1,251.81 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.66 / $328.81 / $1,470.32
| Professional | | $135.66 | $328.81 | $1,470.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.85 / $190.91 / $336.87
| Facility | | $146.85 | $190.91 | $336.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.89 / $344.39 / $573.99
| Professional | | $200.89 | $344.39 | $573.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.35 / $345.00 / $649.91
| Professional | | $190.35 | $345.00 | $649.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.85 / $214.32 / $6,679.00
| Facility | | $124.85 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.73 / $300.39 / $526.30
| Professional | | $237.73 | $300.39 | $526.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.24 / $330.07 / $555.26
| Professional | | $153.24 | $330.07 | $555.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.68 / $386.01 / $386.01
| Professional | | $250.68 | $386.01 | $386.01 |
- 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
- $237.09 / $621.69 / $1,470.32
| Professional | | $237.09 | $621.69 | $1,470.32 |
- 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
- $175.97 / $324.04 / $805.80
| Professional | | $175.97 | $324.04 | $805.80 |