- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.12 / $1,828.24 / $3,394.17
| Facility | | $132.12 | $1,828.24 | $3,394.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.58 / $341.94 / $571.76
| Professional | | $123.58 | $341.94 | $571.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.73 / $2,410.09 / $12,000.00
| Facility | | $415.73 | $2,410.09 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.48 / $711.54 / $3,124.08
| Professional | | $196.48 | $711.54 | $3,124.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.86 / $196.43 / $389.79
| Facility | | $152.86 | $196.43 | $389.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.74 / $644.87 / $1,695.28
| Professional | | $194.74 | $644.87 | $1,695.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $3,111.82
| Facility | | $443.00 | $500.00 | $3,111.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.16 / $452.10 / $1,230.45
| Professional | | $165.16 | $452.10 | $1,230.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.33 / $214.32 / $6,679.00
| Facility | | $129.33 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.74 / $666.13 / $1,052.48
| Professional | | $508.74 | $666.13 | $1,052.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.47 / $535.35 / $1,188.53
| Professional | | $193.47 | $535.35 | $1,188.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,899.73 / $2,899.73 / $2,899.73
| Facility | | $2,899.73 | $2,899.73 | $2,899.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.88 / $2,854.00 / $12,000.00
| Facility | | $890.88 | $2,854.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $455.99 / $1,066.52 / $3,124.08
| Professional | | $455.99 | $1,066.52 | $3,124.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $5,714.00
| Facility | | $1,061.00 | $2,854.00 | $5,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.71 / $719.07 / $1,519.15
| Professional | | $426.71 | $719.07 | $1,519.15 |