- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.34 / $3,627.00 / $8,017.00
| Facility | | $342.34 | $3,627.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.00 / $278.08 / $407.70
| Professional | | $190.00 | $278.08 | $407.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.39 / $303.44 / $514.41
| Professional | | $292.39 | $303.44 | $514.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.45 / $291.43 / $476.31
| Professional | | $189.45 | $291.43 | $476.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.00 / $363.00 / $468.09
| Professional | | $363.00 | $363.00 | $468.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,964.00 / $8,017.00
| Facility | | $832.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.16 / $300.36 / $1,749.00
| Professional | | $191.16 | $300.36 | $1,749.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.20 / $446.20 / $446.20
| Professional | | $446.20 | $446.20 | $446.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.67 / $289.64 / $455.05
| Professional | | $188.67 | $289.64 | $455.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.68 / $259.80 / $525.49
| Facility | | $190.68 | $259.80 | $525.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.95 / $290.94 / $525.49
| Professional | | $188.95 | $290.94 | $525.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.98 / $341.64 / $572.42
| Professional | | $274.98 | $341.64 | $572.42 |