- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.19 / $2,663.12 / $3,693.00
| Facility | | $139.19 | $2,663.12 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.86 / $191.54 / $530.04
| Professional | | $115.86 | $191.54 | $530.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.75 / $559.45 / $2,733.00
| Facility | | $253.75 | $559.45 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.52 / $275.50 / $1,063.59
| Professional | | $111.52 | $275.50 | $1,063.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.38 / $178.61 / $315.17
| Facility | | $137.38 | $178.61 | $315.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.31 / $273.89 / $371.75
| Professional | | $175.31 | $273.89 | $371.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.75 / $276.08 / $566.00
| Professional | | $162.75 | $276.08 | $566.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.24 / $214.32 / $6,679.00
| Facility | | $117.24 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.64 / $170.48 / $274.85
| Professional | | $93.64 | $170.48 | $274.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.41 / $306.51 / $416.03
| Professional | | $144.41 | $306.51 | $416.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.96 / $450.16 / $450.16
| Professional | | $235.96 | $450.16 | $450.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.39 / $430.08 / $1,063.59
| Professional | | $165.39 | $430.08 | $1,063.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.05 / $228.48 / $517.59
| Professional | | $134.05 | $228.48 | $517.59 |