- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.44 / $1,823.00 / $3,363.00
| Facility | | $126.44 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.18 / $161.68 / $240.65
| Professional | | $124.18 | $161.68 | $240.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $941.10 / $12,000.00
| Facility | | $308.00 | $941.10 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.15 / $330.84 / $1,240.72
| Professional | | $152.15 | $330.84 | $1,240.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.97 / $210.70 / $375.82
| Facility | | $163.97 | $210.70 | $375.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.74 / $353.73 / $353.73
| Professional | | $204.74 | $353.73 | $353.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $482.73 / $607.77
| Facility | | $443.00 | $482.73 | $607.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.36 / $282.26 / $533.39
| Professional | | $149.36 | $282.26 | $533.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.13 / $377.00 / $6,679.00
| Facility | | $140.13 | $377.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.22 / $255.65 / $368.31
| Professional | | $198.22 | $255.65 | $368.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.95 / $360.43 / $466.32
| Professional | | $178.95 | $360.43 | $466.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $1,078.00 / $12,000.00
| Facility | | $308.00 | $1,078.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.18 / $422.97 / $1,240.72
| Professional | | $195.18 | $422.97 | $1,240.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $1,078.00 / $2,733.00
| Facility | | $308.00 | $1,078.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.95 / $269.66 / $560.00
| Professional | | $178.95 | $269.66 | $560.00 |