- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.25 / $1,803.00 / $3,363.00
| Facility | | $116.25 | $1,803.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.12 / $181.47 / $300.17
| Professional | | $113.12 | $181.47 | $300.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $396.00 / $1,894.37 / $12,000.00
| Facility | | $396.00 | $1,894.37 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.54 / $346.88 / $1,539.84
| Professional | | $168.54 | $346.88 | $1,539.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.38 / $191.95 / $342.38
| Facility | | $149.38 | $191.95 | $342.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.97 / $452.37 / $1,620.25
| Professional | | $244.97 | $452.37 | $1,620.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $3,103.98
| Facility | | $443.00 | $500.00 | $3,103.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.83 / $288.00 / $556.73
| Professional | | $144.83 | $288.00 | $556.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.12 / $377.00 / $6,679.00
| Facility | | $127.12 | $377.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.35 / $324.99 / $477.41
| Professional | | $249.35 | $324.99 | $477.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.28 / $338.41 / $583.36
| Professional | | $180.28 | $338.41 | $583.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,101.99 / $6,101.99 / $6,101.99
| Facility | | $6,101.99 | $6,101.99 | $6,101.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.00 / $2,338.00 / $12,000.00
| Facility | | $822.00 | $2,338.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.32 / $513.29 / $1,539.84
| Professional | | $234.32 | $513.29 | $1,539.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.00 / $3,372.00 / $8,459.00
| Facility | | $822.00 | $3,372.00 | $8,459.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.35 / $337.02 / $683.66
| Professional | | $212.35 | $337.02 | $683.66 |