- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.04 / $1,978.00 / $7,175.00
| Facility | | $208.04 | $1,978.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.91 / $212.75 / $376.92
| Professional | | $152.91 | $212.75 | $376.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.65 / $236.24 / $236.24
| Professional | | $227.65 | $236.24 | $236.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.18 / $249.84 / $406.01
| Professional | | $174.18 | $249.84 | $406.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.61 / $363.05 / $368.36
| Professional | | $273.61 | $363.05 | $368.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.22 / $3,372.25 / $7,241.71
| Facility | | $682.22 | $3,372.25 | $7,241.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,070.00 / $7,197.00
| Facility | | $540.00 | $2,070.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.15 / $235.38 / $439.88
| Professional | | $161.15 | $235.38 | $439.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $419.20 / $606.20
| Professional | | $3.00 | $419.20 | $606.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.59 / $257.70 / $408.38
| Professional | | $178.59 | $257.70 | $408.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.69 / $208.61 / $431.33
| Facility | | $162.69 | $208.61 | $431.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.69 / $218.31 / $238.40
| Professional | | $162.69 | $218.31 | $238.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.29 / $289.51 / $475.17
| Professional | | $211.29 | $289.51 | $475.17 |