- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.19 / $1,350.77 / $7,629.00
| Facility | | $125.19 | $1,350.77 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.99 / $188.73 / $254.80
| Professional | | $114.99 | $188.73 | $254.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.59 / $205.05 / $205.05
| Professional | | $197.59 | $205.05 | $205.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.62 / $210.20 / $365.35
| Professional | | $129.62 | $210.20 | $365.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.30 / $318.42 / $329.32
| Professional | | $240.30 | $318.42 | $329.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.35 / $1,050.39 / $2,048.07
| Facility | | $534.35 | $1,050.39 | $2,048.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.14 / $1,569.00 / $8,017.00
| Facility | | $250.14 | $1,569.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.12 / $204.75 / $470.94
| Professional | | $116.12 | $204.75 | $470.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $136.90 / $553.79
| Professional | | $5.00 | $136.90 | $553.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.19 / $215.86 / $386.94
| Professional | | $133.19 | $215.86 | $386.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.61 / $141.60 / $218.97
| Facility | | $114.61 | $141.60 | $218.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.69 / $192.19 / $210.91
| Professional | | $113.69 | $192.19 | $210.91 |
- 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
- $172.51 / $252.14 / $403.64
| Professional | | $172.51 | $252.14 | $403.64 |