- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.49 / $2,079.00 / $3,625.00
| Facility | | $251.49 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.45 / $223.06 / $449.16
| Professional | | $116.45 | $223.06 | $449.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.52 / $716.81 / $2,713.00
| Facility | | $267.52 | $716.81 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $329.93 / $960.22
| Professional | | $131.83 | $329.93 | $960.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.33 / $178.53 / $350.19
| Facility | | $137.33 | $178.53 | $350.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.54 / $329.87 / $583.46
| Professional | | $192.54 | $329.87 | $583.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $210.10
| Facility | | $50.00 | $50.00 | $210.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.31 / $347.29 / $744.83
| Professional | | $147.31 | $347.29 | $744.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.45 / $214.32 / $6,679.00
| Facility | | $117.45 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.79 / $365.89 / $510.65
| Professional | | $288.79 | $365.89 | $510.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.49 / $314.98 / $723.82
| Professional | | $140.49 | $314.98 | $723.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.80 / $419.80 / $867.00
| Professional | | $419.80 | $419.80 | $867.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.63 / $465.08 / $2,462.08
| Professional | | $278.63 | $465.08 | $2,462.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $1,790.00 / $2,733.00
| Facility | | $500.00 | $1,790.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.87 / $387.65 / $792.80
| Professional | | $261.87 | $387.65 | $792.80 |