- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $2,131.00 / $7,513.00
| Facility | | $425.00 | $2,131.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.30 / $95.25 / $231.78
| Professional | | $64.30 | $95.25 | $231.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.74 / $56.16 / $84.67
| Professional | | $47.74 | $56.16 | $84.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.96 / $55.96 / $98.32
| Facility | | $55.96 | $55.96 | $98.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.31 / $127.31 / $127.31
| Professional | | $127.31 | $127.31 | $127.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.70 / $322.86 / $322.86
| Facility | | $296.70 | $322.86 | $322.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.80 / $722.96 / $809.93
| Professional | | $486.80 | $722.96 | $809.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.29 / $93.65 / $126.78
| Facility | | $63.29 | $93.65 | $126.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.25 / $117.92 / $171.76
| Professional | | $79.25 | $117.92 | $171.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.29 / $93.65 / $127.44
| Facility | | $63.29 | $93.65 | $127.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.27 / $127.31 / $269.55
| Professional | | $62.27 | $127.31 | $269.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $949.00 / $2,376.00
| Facility | | $161.00 | $949.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.01 / $109.35 / $166.32
| Professional | | $82.01 | $109.35 | $166.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.44 / $92.53 / $129.54
| Professional | | $81.44 | $92.53 | $129.54 |