- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $1,886.00 / $3,625.00
| Facility | | $144.54 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.94 / $105.88 / $214.40
| Professional | | $50.94 | $105.88 | $214.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.53 / $1,177.70 / $3,472.00
| Facility | | $70.53 | $1,177.70 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.34 / $143.76 / $1,026.19
| Professional | | $55.34 | $143.76 | $1,026.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.11 / $64.39 / $123.26
| Facility | | $50.11 | $64.39 | $123.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.39 / $126.10 / $274.48
| Professional | | $64.39 | $126.10 | $274.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.34 / $275.14 / $6,679.00
| Facility | | $51.34 | $275.14 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.23 / $111.08 / $153.33
| Professional | | $91.23 | $111.08 | $153.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.34 / $118.86 / $234.24
| Professional | | $56.34 | $118.86 | $234.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.83 / $693.55 / $799.05
| Facility | | $612.83 | $693.55 | $799.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.71 / $126.81 / $127.87
| Professional | | $124.71 | $126.81 | $127.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,600.00 / $7,161.00
| Facility | | $55.00 | $1,600.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.30 / $227.12 / $1,026.19
| Professional | | $93.30 | $227.12 | $1,026.19 |
- 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
- $86.74 / $172.51 / $330.29
| Professional | | $86.74 | $172.51 | $330.29 |