- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.72 / $2,663.12 / $3,693.00
| Facility | | $129.72 | $2,663.12 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.31 / $221.43 / $455.17
| Professional | | $117.31 | $221.43 | $455.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.32 / $1,267.00 / $3,381.00
| Facility | | $200.32 | $1,267.00 | $3,381.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.14 / $500.70 / $2,244.96
| Professional | | $209.14 | $500.70 | $2,244.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.93 / $289.04 / $515.54
| Facility | | $224.93 | $289.04 | $515.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.16 / $540.91 / $540.91
| Professional | | $98.16 | $540.91 | $540.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.05 / $531.38 / $748.00
| Facility | | $422.05 | $531.38 | $748.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.38 / $407.60 / $900.59
| Professional | | $185.38 | $407.60 | $900.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.26 / $300.00 / $6,679.00
| Facility | | $168.26 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.24 / $458.74 / $676.21
| Professional | | $359.24 | $458.74 | $676.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.18 / $507.17 / $924.22
| Professional | | $270.18 | $507.17 | $924.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.66 / $240.66 / $240.66
| Professional | | $240.66 | $240.66 | $240.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,273.98 / $3,804.00
| Facility | | $55.00 | $1,273.98 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.16 / $707.30 / $2,244.96
| Professional | | $246.16 | $707.30 | $2,244.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.00 / $1,878.00 / $4,142.00
| Facility | | $473.00 | $1,878.00 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.07 / $431.34 / $979.44
| Professional | | $217.07 | $431.34 | $979.44 |