- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.56 / $3,060.00 / $10,546.00
| Facility | | $266.56 | $3,060.00 | $10,546.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.91 / $212.42 / $306.47
| Professional | | $155.91 | $212.42 | $306.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,471.03 / $7,275.80 / $14,454.58
| Facility | | $3,471.03 | $7,275.80 | $14,454.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.94 / $216.84 / $348.25
| Professional | | $149.94 | $216.84 | $348.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.41 / $149.41 / $233.20
| Facility | | $149.41 | $149.41 | $233.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,024.00 / $3,741.00 / $4,187.68
| Facility | | $2,024.00 | $3,741.00 | $4,187.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.60 / $244.35 / $418.43
| Professional | | $166.60 | $244.35 | $418.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,139.04 / $2,000.00
| Facility | | $55.00 | $1,139.04 | $2,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,185.28 / $1,624.32 / $1,883.03
| Professional | | $1,185.28 | $1,624.32 | $1,883.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.65 / $225.47 / $377.93
| Facility | | $160.65 | $225.47 | $377.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.05 / $283.43 / $392.44
| Professional | | $206.05 | $283.43 | $392.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $212.40 / $603.29
| Professional | | $5.00 | $212.40 | $603.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.65 / $226.69 / $442.95
| Facility | | $160.65 | $226.69 | $442.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.81 / $266.07 / $481.87
| Professional | | $172.81 | $266.07 | $481.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $2,045.00 / $4,480.00
| Facility | | $593.00 | $2,045.00 | $4,480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.89 / $234.94 / $377.33
| Professional | | $173.89 | $234.94 | $377.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.07 / $217.76 / $295.52
| Professional | | $186.07 | $217.76 | $295.52 |