- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.22 / $2,079.00 / $3,685.00
| Facility | | $226.22 | $2,079.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.26 / $239.13 / $2,923.69
| Professional | | $194.26 | $239.13 | $2,923.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $1,546.15 / $7,958.00
| Facility | | $471.00 | $1,546.15 | $7,958.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.81 / $459.82 / $4,265.53
| Professional | | $206.81 | $459.82 | $4,265.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.33 / $291.18 / $514.61
| Facility | | $224.33 | $291.18 | $514.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.64 / $431.03 / $892.61
| Professional | | $253.64 | $431.03 | $892.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.83 / $409.04 / $6,679.00
| Facility | | $195.83 | $409.04 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.90 / $272.68 / $439.62
| Professional | | $146.90 | $272.68 | $439.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.28 / $512.44 / $736.25
| Professional | | $247.28 | $512.44 | $736.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,583.45 / $4,583.45 / $4,583.45
| Facility | | $4,583.45 | $4,583.45 | $4,583.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.00 / $600.85 / $600.85
| Professional | | $289.00 | $600.85 | $600.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,018.15 / $2,430.00 / $12,000.00
| Facility | | $1,018.15 | $2,430.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.77 / $635.41 / $4,265.53
| Professional | | $299.77 | $635.41 | $4,265.53 |
- 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
- $292.32 / $452.63 / $744.35
| Professional | | $292.32 | $452.63 | $744.35 |