- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.00 / $2,483.00 / $7,175.00
| Facility | | $379.00 | $2,483.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.92 / $166.12 / $297.39
| Professional | | $86.92 | $166.12 | $297.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.13 / $169.29 / $331.14
| Professional | | $163.13 | $169.29 | $331.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.20 / $175.08 / $308.58
| Professional | | $101.20 | $175.08 | $308.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.56 / $263.24 / $271.43
| Professional | | $198.56 | $263.24 | $271.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $999.35 / $2,194.80 / $13,545.00
| Facility | | $999.35 | $2,194.80 | $13,545.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.81 / $142.81 / $142.81
| Professional | | $142.81 | $142.81 | $142.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.15 / $2,326.00 / $7,799.00
| Facility | | $540.15 | $2,326.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.34 / $179.58 / $403.75
| Professional | | $91.34 | $179.58 | $403.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $132.40 / $457.10
| Professional | | $5.00 | $132.40 | $457.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.19 / $178.35 / $339.74
| Professional | | $103.19 | $178.35 | $339.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.06 / $158.19 / $163.52
| Facility | | $86.06 | $158.19 | $163.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.64 / $158.19 / $176.90
| Professional | | $85.64 | $158.19 | $176.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.04 / $202.80 / $315.83
| Professional | | $139.04 | $202.80 | $315.83 |