- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.49 / $2,605.00 / $8,017.00
| Facility | | $232.49 | $2,605.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.25 / $188.66 / $263.93
| Professional | | $115.25 | $188.66 | $263.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.70 / $258.25 / $378.89
| Professional | | $177.70 | $258.25 | $378.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.77 / $209.15 / $374.68
| Professional | | $129.77 | $209.15 | $374.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.83 / $326.17 / $335.50
| Professional | | $245.83 | $326.17 | $335.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,733.47 / $4,757.58 / $6,384.12
| Facility | | $2,733.47 | $4,757.58 | $6,384.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,679.00 / $8,017.00
| Facility | | $832.00 | $2,679.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.44 / $206.09 / $667.37
| Professional | | $121.44 | $206.09 | $667.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $154.80 / $577.50
| Professional | | $5.00 | $154.80 | $577.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.91 / $218.08 / $388.91
| Professional | | $137.91 | $218.08 | $388.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.84 / $127.23 / $205.64
| Facility | | $117.84 | $127.23 | $205.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.67 / $181.89 / $222.72
| Professional | | $124.67 | $181.89 | $222.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.43 / $241.91 / $395.15
| Professional | | $168.43 | $241.91 | $395.15 |