- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.62 / $334.31 / $1,359.00
| Facility | | $303.62 | $334.31 | $1,359.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.20 / $315.02 / $406.36
| Professional | | $285.20 | $315.02 | $406.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.49 / $481.31 / $481.31
| Professional | | $306.49 | $481.31 | $481.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.52 / $330.55 / $546.60
| Professional | | $318.52 | $330.55 | $546.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.92 / $508.92 / $508.92
| Facility | | $508.92 | $508.92 | $508.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.50 / $409.78 / $699.49
| Professional | | $300.50 | $409.78 | $699.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.98 / $464.31 / $631.83
| Professional | | $319.98 | $464.31 | $631.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.82 / $378.21 / $451.56
| Professional | | $343.82 | $378.21 | $451.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.31 / $340.62 / $1,812.00
| Facility | | $334.31 | $340.62 | $1,812.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.22 / $329.45 / $547.04
| Professional | | $293.22 | $329.45 | $547.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.37 / $408.05 / $619.61
| Professional | | $301.37 | $408.05 | $619.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.92 / $508.92 / $508.92
| Facility | | $508.92 | $508.92 | $508.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.50 / $409.97 / $724.40
| Professional | | $300.50 | $409.97 | $724.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.99 / $311.05 / $363.57
| Facility | | $305.99 | $311.05 | $363.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.95 / $311.27 / $356.88
| Professional | | $302.95 | $311.27 | $356.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.50 / $373.25 / $632.75
| Professional | | $300.50 | $373.25 | $632.75 |