- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.50 / $1,199.50 / $3,103.52
| Facility | | $355.50 | $1,199.50 | $3,103.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.05 / $110.26 / $194.22
| Professional | | $62.05 | $110.26 | $194.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.72 / $1,483.60 / $7,161.00
| Facility | | $159.72 | $1,483.60 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.63 / $201.54 / $1,504.73
| Professional | | $82.63 | $201.54 | $1,504.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.69 / $101.12 / $200.66
| Facility | | $78.69 | $101.12 | $200.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.39 / $201.07 / $408.32
| Professional | | $99.39 | $201.07 | $408.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.68 / $157.16 / $297.08
| Professional | | $89.68 | $157.16 | $297.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.58 / $234.93 / $6,679.00
| Facility | | $74.58 | $234.93 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.41 / $185.83 / $256.41
| Professional | | $153.41 | $185.83 | $256.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.46 / $189.15 / $392.72
| Professional | | $89.46 | $189.15 | $392.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.11 / $542.15 / $859.40
| Facility | | $191.11 | $542.15 | $859.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.94 / $190.61 / $245.57
| Professional | | $107.94 | $190.61 | $245.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.49 / $2,078.00 / $12,000.00
| Facility | | $336.49 | $2,078.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.44 / $270.30 / $1,504.73
| Professional | | $139.44 | $270.30 | $1,504.73 |
- 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
- $130.15 / $217.79 / $385.73
| Professional | | $130.15 | $217.79 | $385.73 |