- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.89 / $2,747.00 / $8,017.00
| Facility | | $407.89 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.51 / $324.97 / $482.63
| Professional | | $220.51 | $324.97 | $482.63 |
- 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
- $357.79 / $371.29 / $650.60
| Professional | | $357.79 | $371.29 | $650.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.00 / $771.00 / $771.00
| Facility | | $771.00 | $771.00 | $771.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.48 / $325.02 / $544.46
| Professional | | $210.48 | $325.02 | $544.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.33 / $438.33 / $565.24
| Professional | | $438.33 | $438.33 | $565.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,120.00 / $8,017.00
| Facility | | $918.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.84 / $359.39 / $1,544.00
| Professional | | $226.84 | $359.39 | $1,544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.70 / $499.70 / $499.70
| Professional | | $499.70 | $499.70 | $499.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.00 / $771.00 / $771.00
| Facility | | $771.00 | $771.00 | $771.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.79 / $325.02 / $538.90
| Professional | | $210.79 | $325.02 | $538.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.12 / $248.74 / $571.45
| Facility | | $227.12 | $248.74 | $571.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.59 / $351.18 / $571.45
| Professional | | $226.59 | $351.18 | $571.45 |
- 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
- $329.87 / $416.20 / $677.75
| Professional | | $329.87 | $416.20 | $677.75 |