- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.75 / $1,473.20 / $3,363.00
| Facility | | $166.75 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.61 / $170.01 / $425.60
| Professional | | $108.61 | $170.01 | $425.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.86 / $1,177.70 / $3,472.00
| Facility | | $187.86 | $1,177.70 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.12 / $272.82 / $826.56
| Professional | | $127.12 | $272.82 | $826.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.33 / $172.61 / $308.14
| Facility | | $134.33 | $172.61 | $308.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.14 / $278.95 / $546.16
| Professional | | $171.14 | $278.95 | $546.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.76 / $256.35 / $460.63
| Professional | | $152.76 | $256.35 | $460.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.38 / $214.32 / $6,679.00
| Facility | | $116.38 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.58 / $248.46 / $342.97
| Professional | | $204.58 | $248.46 | $342.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.53 / $316.51 / $547.83
| Professional | | $150.53 | $316.51 | $547.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $959.99 / $959.99 / $1,028.01
| Facility | | $959.99 | $959.99 | $1,028.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.00 / $318.25 / $819.40
| Professional | | $285.00 | $318.25 | $819.40 |
- 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
- $187.25 / $335.35 / $1,272.72
| Professional | | $187.25 | $335.35 | $1,272.72 |
- 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
- $169.50 / $266.98 / $502.86
| Professional | | $169.50 | $266.98 | $502.86 |