- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.84 / $2,067.00 / $3,625.00
| Facility | | $161.84 | $2,067.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.72 / $170.90 / $321.01
| Professional | | $124.72 | $170.90 | $321.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.31 / $1,267.00 / $3,472.00
| Facility | | $281.31 | $1,267.00 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.52 / $296.24 / $1,276.72
| Professional | | $135.52 | $296.24 | $1,276.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.57 / $181.44 / $320.17
| Facility | | $139.57 | $181.44 | $320.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.84 / $278.58 / $438.02
| Professional | | $200.84 | $278.58 | $438.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.27 / $295.98 / $557.92
| Professional | | $171.27 | $295.98 | $557.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.87 / $214.32 / $6,679.00
| Facility | | $121.87 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.34 / $203.27 / $327.71
| Professional | | $110.34 | $203.27 | $327.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.08 / $331.76 / $486.51
| Professional | | $154.08 | $331.76 | $486.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $144.54 / $940.36
| Facility | | $144.54 | $144.54 | $940.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.70 / $289.07 / $358.64
| Professional | | $166.70 | $289.07 | $358.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,878.00 / $7,161.00
| Facility | | $55.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.97 / $441.60 / $1,276.72
| Professional | | $209.97 | $441.60 | $1,276.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.24 / $272.08 / $651.52
| Professional | | $196.24 | $272.08 | $651.52 |