- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.22 / $2,067.00 / $3,625.00
| Facility | | $219.22 | $2,067.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.75 / $179.36 / $335.25
| Professional | | $82.75 | $179.36 | $335.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.41 / $1,177.70 / $7,161.00
| Facility | | $207.41 | $1,177.70 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.85 / $286.22 / $1,410.78
| Professional | | $97.85 | $286.22 | $1,410.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.27 / $135.27 / $268.44
| Facility | | $105.27 | $135.27 | $268.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.93 / $198.78 / $424.13
| Professional | | $119.93 | $198.78 | $424.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.33 / $222.02 / $469.55
| Professional | | $114.33 | $222.02 | $469.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.70 / $300.00 / $6,679.00
| Facility | | $91.70 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.83 / $260.88 / $360.41
| Professional | | $213.83 | $260.88 | $360.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.86 / $255.53 / $553.16
| Professional | | $120.86 | $255.53 | $553.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,928.58 / $1,928.58 / $1,928.58
| Facility | | $1,928.58 | $1,928.58 | $1,928.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.00 / $131.50 / $144.10
| Professional | | $104.00 | $131.50 | $144.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $519.95 / $2,078.00 / $12,000.00
| Facility | | $519.95 | $2,078.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.06 / $411.57 / $1,410.78
| Professional | | $213.06 | $411.57 | $1,410.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $950.00 / $2,408.00 / $7,161.00
| Facility | | $950.00 | $2,408.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.13 / $305.60 / $581.46
| Professional | | $202.13 | $305.60 | $581.46 |