- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.11 / $212.92 / $14,482.00
| Facility | | $124.11 | $212.92 | $14,482.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.43 / $124.11 / $369.10
| Professional | | $82.43 | $124.11 | $369.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.96 / $261.23 / $452.01
| Professional | | $103.96 | $261.23 | $452.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.73 / $311.70 / $502.76
| Facility | | $266.73 | $311.70 | $502.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.09 / $308.11 / $355.09
| Professional | | $159.09 | $308.11 | $355.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.63 / $124.11 / $203.45
| Facility | | $94.63 | $124.11 | $203.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.09 / $777.80 / $1,789.00
| Facility | | $104.09 | $777.80 | $1,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.54 / $269.16 / $529.29
| Professional | | $124.54 | $269.16 | $529.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.00 / $140.12 / $334.99
| Professional | | $70.00 | $140.12 | $334.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.63 / $124.11 / $203.45
| Facility | | $94.63 | $124.11 | $203.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.40 / $302.00 / $381.56
| Professional | | $218.40 | $302.00 | $381.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $1,300.00 / $1,300.00
| Facility | | $1,300.00 | $1,300.00 | $1,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.94 / $518.90 / $796.48
| Professional | | $150.94 | $518.90 | $796.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.51 / $193.51 / $193.51
| Professional | | $193.51 | $193.51 | $193.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.06 / $324.77 / $324.77
| Professional | | $191.06 | $324.77 | $324.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,034.00 / $1,423.00 / $2,202.90
| Facility | | $1,034.00 | $1,423.00 | $2,202.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.54 / $273.37 / $454.82
| Professional | | $124.54 | $273.37 | $454.82 |