- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $3,019.95 / $5,623.41
| Facility | | $100.00 | $3,019.95 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $117.49 / $288.40
| Professional | | $81.28 | $117.49 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $6,309.57 / $45,708.82
| Facility | | $239.88 | $6,309.57 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $173.78 / $467.74
| Professional | | $95.50 | $173.78 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $112.20 / $257.04
| Facility | | $112.20 | $112.20 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $309.03 / $501.19
| Professional | | $194.98 | $309.03 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $204.17 / $407.38
| Professional | | $109.65 | $204.17 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $707.95 / $7,079.46
| Facility | | $87.10 | $707.95 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $147.91 / $251.19
| Professional | | $91.20 | $147.91 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $173.78 / $371.54
| Professional | | $102.33 | $173.78 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,265.80 / $5,370.32
| Facility | | $2,344.23 | $4,265.80 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $6,456.54 / $45,708.82
| Facility | | $239.88 | $6,456.54 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $173.78 / $457.09
| Professional | | $95.50 | $173.78 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $12,022.64
| Facility | | $2,041.74 | $5,248.07 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $177.83 / $380.19
| Professional | | $102.33 | $177.83 | $380.19 |