- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.63 / $530.83 / $3,717.00
| Facility | | $150.63 | $530.83 | $3,717.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.70 / $180.00 / $245.64
| Professional | | $102.70 | $180.00 | $245.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.97 / $193.23 / $300.00
| Professional | | $158.97 | $193.23 | $300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.81 / $146.10 / $451.00
| Facility | | $109.81 | $146.10 | $451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.81 / $146.10 / $255.91
| Professional | | $109.81 | $146.10 | $255.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.96 / $6,291.00 / $6,990.00
| Facility | | $112.96 | $6,291.00 | $6,990.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.91 / $78.91 / $78.91
| Professional | | $78.91 | $78.91 | $78.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.97 / $161.00 / $332.00
| Facility | | $59.97 | $161.00 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.05 / $138.47 / $195.86
| Professional | | $112.05 | $138.47 | $195.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.72 / $130.43 / $222.49
| Professional | | $76.72 | $130.43 | $222.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.75 / $524.87 / $565.04
| Facility | | $375.75 | $524.87 | $565.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.73 / $176.73 / $176.73
| Professional | | $176.73 | $176.73 | $176.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.96 / $597.00 / $6,990.00
| Facility | | $112.96 | $597.00 | $6,990.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.91 / $78.91 / $500.00
| Professional | | $78.91 | $78.91 | $500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.66 / $182.75 / $440.56
| Professional | | $108.66 | $182.75 | $440.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.28 / $101.28 / $101.28
| Facility | | $101.28 | $101.28 | $101.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.04 / $125.79 / $222.49
| Professional | | $83.04 | $125.79 | $222.49 |