- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.83 / $2,079.00 / $3,685.00
| Facility | | $70.83 | $2,079.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.40 / $76.23 / $329.48
| Professional | | $57.40 | $76.23 | $329.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.28 / $736.00 / $7,231.00
| Facility | | $135.28 | $736.00 | $7,231.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.48 / $134.90 / $1,520.20
| Professional | | $58.48 | $134.90 | $1,520.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.84 / $84.18 / $148.77
| Facility | | $64.84 | $84.18 | $148.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.04 / $116.40 / $177.12
| Professional | | $90.04 | $116.40 | $177.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.42 / $129.44 / $256.64
| Professional | | $81.42 | $129.44 | $256.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.41 / $300.00 / $6,679.00
| Facility | | $66.41 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.64 / $82.01 / $128.00
| Professional | | $42.64 | $82.01 | $128.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.79 / $148.77 / $211.97
| Professional | | $71.79 | $148.77 | $211.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,718.81 / $1,718.81 / $1,718.81
| Facility | | $1,718.81 | $1,718.81 | $1,718.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.11 / $45.40 / $112.58
| Professional | | $43.11 | $45.40 | $112.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.93 / $2,028.00 / $12,000.00
| Facility | | $275.93 | $2,028.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.27 / $199.52 / $1,520.20
| Professional | | $90.27 | $199.52 | $1,520.20 |
- 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
- $88.65 / $126.41 / $273.68
| Professional | | $88.65 | $126.41 | $273.68 |