- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,240.00 / $7,629.00
| Facility | | $617.00 | $2,240.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.88 / $1,234.00 / $2,157.82
| Professional | | $155.88 | $1,234.00 | $2,157.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,489.17 / $2,900.40 / $3,364.17
| Professional | | $1,489.17 | $2,900.40 | $3,364.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.08 / $484.47 / $3,028.64
| Professional | | $209.08 | $484.47 | $3,028.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,085.46 / $2,766.74 / $2,878.70
| Professional | | $2,085.46 | $2,766.74 | $2,878.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,371.00 / $8,017.00
| Facility | | $641.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.76 / $1,420.18 / $2,691.08
| Professional | | $161.76 | $1,420.18 | $2,691.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,295.80 / $5,295.80 / $5,295.80
| Professional | | $5,295.80 | $5,295.80 | $5,295.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.45 / $520.11 / $3,222.68
| Professional | | $212.45 | $520.11 | $3,222.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.79 / $226.17 / $1,782.94
| Facility | | $172.79 | $226.17 | $1,782.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.79 / $1,736.87 / $1,937.26
| Professional | | $172.79 | $1,736.87 | $1,937.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,698.06 / $2,288.44 / $3,701.40
| Professional | | $1,698.06 | $2,288.44 | $3,701.40 |