- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,528.00 / $2,894.76 / $6,075.00
| Facility | | $2,528.00 | $2,894.76 | $6,075.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.40 / $161.63 / $648.00
| Professional | | $107.40 | $161.63 | $648.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.36 / $4,842.46 / $15,220.00
| Facility | | $317.36 | $4,842.46 | $15,220.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.53 / $260.01 / $1,068.90
| Professional | | $142.53 | $260.01 | $1,068.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.69 / $248.77 / $428.88
| Professional | | $180.69 | $248.77 | $428.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.79 / $268.20 / $486.08
| Professional | | $149.79 | $268.20 | $486.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.68 / $300.00 / $6,679.00
| Facility | | $131.68 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.56 / $148.13 / $238.84
| Professional | | $79.56 | $148.13 | $238.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.25 / $327.58 / $498.62
| Professional | | $164.25 | $327.58 | $498.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.50 / $97.50 / $97.50
| Professional | | $97.50 | $97.50 | $97.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $6,104.00 / $26,542.00
| Facility | | $1,485.00 | $6,104.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.30 / $277.57 / $1,068.90
| Professional | | $175.30 | $277.57 | $1,068.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.73 / $207.44 / $435.62
| Professional | | $166.73 | $207.44 | $435.62 |