- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.33 / $2,124.00 / $6,762.00
| Facility | | $266.33 | $2,124.00 | $6,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.14 / $193.54 / $282.45
| Professional | | $99.14 | $193.54 | $282.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,062.88 / $3,680.36 / $7,524.82
| Facility | | $2,062.88 | $3,680.36 | $7,524.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.22 / $184.04 / $329.15
| Professional | | $96.22 | $184.04 | $329.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.07 / $97.07 / $236.60
| Facility | | $97.07 | $97.07 | $236.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,322.00 / $1,818.57 / $2,361.01
| Facility | | $1,322.00 | $1,818.57 | $2,361.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.68 / $211.47 / $385.50
| Professional | | $116.68 | $211.47 | $385.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.50 / $11,500.00 / $12,000.00
| Facility | | $595.50 | $11,500.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $902.00 / $1,561.20 / $1,880.93
| Professional | | $902.00 | $1,561.20 | $1,880.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.29 / $211.97 / $355.43
| Facility | | $104.29 | $211.97 | $355.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.15 / $235.19 / $384.86
| Professional | | $134.15 | $235.19 | $384.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.02 / $233.76 / $506.95
| Professional | | $107.02 | $233.76 | $506.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.90 / $213.67 / $371.25
| Facility | | $104.90 | $213.67 | $371.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.86 / $233.44 / $467.17
| Professional | | $120.86 | $233.44 | $467.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,190.00 / $3,239.00 / $7,600.00
| Facility | | $1,190.00 | $3,239.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.56 / $229.46 / $354.62
| Professional | | $167.56 | $229.46 | $354.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.48 / $212.72 / $288.45
| Professional | | $182.48 | $212.72 | $288.45 |