- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.00 / $2,079.00 / $4,088.00
| Facility | | $537.00 | $2,079.00 | $4,088.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.25 / $148.69 / $304.35
| Professional | | $102.25 | $148.69 | $304.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.11 / $2,329.00 / $4,755.00
| Facility | | $224.11 | $2,329.00 | $4,755.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.16 / $258.33 / $1,082.16
| Professional | | $114.16 | $258.33 | $1,082.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.04 / $154.75 / $273.08
| Facility | | $119.04 | $154.75 | $273.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.60 / $237.60 / $356.27
| Professional | | $237.60 | $237.60 | $356.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.49 / $262.49 / $523.42
| Professional | | $152.49 | $262.49 | $523.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.47 / $214.32 / $6,679.00
| Facility | | $103.47 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.37 / $178.40 / $276.56
| Professional | | $93.37 | $178.40 | $276.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.88 / $277.52 / $406.48
| Professional | | $128.88 | $277.52 | $406.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,029.11 / $1,495.87 / $4,320.31
| Facility | | $1,029.11 | $1,495.87 | $4,320.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.03 / $163.88 / $352.00
| Professional | | $82.03 | $163.88 | $352.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,376.00 / $8,498.00
| Facility | | $55.00 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.39 / $441.69 / $1,082.16
| Professional | | $172.39 | $441.69 | $1,082.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.89 / $258.33 / $530.03
| Professional | | $167.89 | $258.33 | $530.03 |