- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.36 / $1,823.00 / $3,633.41
| Facility | | $216.36 | $1,823.00 | $3,633.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.29 / $220.14 / $678.33
| Professional | | $108.29 | $220.14 | $678.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.62 / $1,689.00 / $12,000.00
| Facility | | $365.62 | $1,689.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.80 / $340.17 / $1,521.76
| Professional | | $172.80 | $340.17 | $1,521.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.16 / $171.12 / $305.49
| Facility | | $133.16 | $171.12 | $305.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.05 / $295.83 / $544.67
| Professional | | $180.05 | $295.83 | $544.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $1,463.30
| Facility | | $443.00 | $500.00 | $1,463.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.71 / $284.31 / $597.76
| Professional | | $138.71 | $284.31 | $597.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.21 / $377.00 / $6,679.00
| Facility | | $113.21 | $377.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.08 / $322.81 / $466.28
| Professional | | $247.08 | $322.81 | $466.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.87 / $301.22 / $577.03
| Professional | | $163.87 | $301.22 | $577.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,478.85 / $2,478.85 / $2,478.85
| Facility | | $2,478.85 | $2,478.85 | $2,478.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.38 / $338.20 / $357.03
| Professional | | $170.38 | $338.20 | $357.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $756.96 / $2,338.00 / $12,000.00
| Facility | | $756.96 | $2,338.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.94 / $519.02 / $1,521.76
| Professional | | $237.94 | $519.02 | $1,521.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.00 / $2,338.00 / $4,952.00
| Facility | | $669.00 | $2,338.00 | $4,952.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.96 / $328.19 / $691.44
| Professional | | $213.96 | $328.19 | $691.44 |