- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.96 / $832.00 / $8,017.00
| Facility | | $102.96 | $832.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.84 / $106.98 / $232.50
| Professional | | $77.84 | $106.98 | $232.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.60 / $119.97 / $183.11
| Professional | | $115.60 | $119.97 | $183.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.42 / $133.31 / $213.51
| Professional | | $89.42 | $133.31 | $213.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.27 / $184.69 / $188.53
| Professional | | $139.27 | $184.69 | $188.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.75 / $451.75 / $451.75
| Facility | | $451.75 | $451.75 | $451.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.00 / $3,964.00 / $8,427.00
| Facility | | $379.00 | $3,964.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.68 / $119.54 / $305.79
| Professional | | $83.68 | $119.54 | $305.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $141.60 / $302.20
| Professional | | $3.00 | $141.60 | $302.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.21 / $133.80 / $214.91
| Professional | | $93.21 | $133.80 | $214.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.65 / $89.37 / $140.22
| Facility | | $83.65 | $89.37 | $140.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.45 / $109.69 / $119.79
| Professional | | $83.45 | $109.69 | $119.79 |
- 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
- $107.79 / $136.03 / $216.82
| Professional | | $107.79 | $136.03 | $216.82 |