- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.76 / $2,747.00 / $4,806.64
| Facility | | $54.76 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.76 / $126.37 / $370.78
| Professional | | $54.76 | $126.37 | $370.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.63 / $2,329.00 / $4,755.00
| Facility | | $143.63 | $2,329.00 | $4,755.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.12 / $218.05 / $1,018.80
| Professional | | $78.12 | $218.05 | $1,018.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.17 / $100.32 / $196.78
| Facility | | $77.17 | $100.32 | $196.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.55 / $126.55 / $286.74
| Professional | | $126.55 | $126.55 | $286.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.92 / $225.67 / $468.60
| Professional | | $102.92 | $225.67 | $468.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.28 / $168.26 / $6,679.00
| Facility | | $77.28 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.10 / $208.63 / $373.01
| Professional | | $165.10 | $208.63 | $373.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.29 / $177.82 / $387.39
| Professional | | $82.29 | $177.82 | $387.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.84 / $139.84 / $139.84
| Professional | | $139.84 | $139.84 | $139.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,376.00 / $8,498.00
| Facility | | $55.00 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.87 / $392.52 / $1,018.80
| Professional | | $151.87 | $392.52 | $1,018.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.10 / $224.61 / $492.35
| Professional | | $103.10 | $224.61 | $492.35 |