- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.91 / $1,803.00 / $3,363.00
| Facility | | $133.91 | $1,803.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.90 / $173.76 / $299.92
| Professional | | $118.90 | $173.76 | $299.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $680.72 / $2,707.00
| Facility | | $75.00 | $680.72 | $2,707.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.47 / $336.08 / $1,474.48
| Professional | | $158.47 | $336.08 | $1,474.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.88 / $191.31 / $341.23
| Facility | | $148.88 | $191.31 | $341.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.97 / $323.92 / $540.14
| Professional | | $189.97 | $323.92 | $540.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $443.00 / $500.00
| Facility | | $443.00 | $443.00 | $500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.06 / $285.43 / $559.11
| Professional | | $157.06 | $285.43 | $559.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.97 / $214.32 / $6,679.00
| Facility | | $125.97 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.71 / $305.56 / $439.38
| Professional | | $236.71 | $305.56 | $439.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.07 / $345.45 / $558.87
| Professional | | $183.07 | $345.45 | $558.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.23 / $264.23 / $264.23
| Professional | | $264.23 | $264.23 | $264.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $867.72 / $2,733.00
| Facility | | $55.00 | $867.72 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.31 / $487.56 / $1,474.48
| Professional | | $219.31 | $487.56 | $1,474.48 |
- 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
- $201.60 / $320.02 / $633.69
| Professional | | $201.60 | $320.02 | $633.69 |