- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.97 / $1,978.00 / $7,629.00
| Facility | | $254.97 | $1,978.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.07 / $209.50 / $652.00
| Professional | | $124.07 | $209.50 | $652.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.17 / $390.79 / $480.36
| Professional | | $332.17 | $390.79 | $480.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.54 / $276.47 / $423.92
| Professional | | $228.54 | $276.47 | $423.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.62 / $239.61 / $417.81
| Professional | | $164.62 | $239.61 | $417.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.00 / $150.00 / $422.94
| Professional | | $150.00 | $150.00 | $422.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,492.00 / $2,492.00 / $2,492.00
| Facility | | $2,492.00 | $2,492.00 | $2,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.00 / $2,070.00 / $7,799.00
| Facility | | $536.00 | $2,070.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.47 / $266.64 / $630.00
| Professional | | $136.47 | $266.64 | $630.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.69 / $172.40 / $685.00
| Professional | | $152.69 | $172.40 | $685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.37 / $245.47 / $417.81
| Professional | | $162.37 | $245.47 | $417.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.12 / $176.59 / $258.80
| Facility | | $135.12 | $176.59 | $258.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.28 / $185.34 / $275.82
| Professional | | $159.28 | $185.34 | $275.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,228.00
| Facility | | $625.00 | $2,391.00 | $6,228.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.71 / $259.08 / $435.60
| Professional | | $142.71 | $259.08 | $435.60 |