- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $2,128.00 / $7,316.00
| Facility | | $425.00 | $2,128.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.17 / $174.46 / $255.93
| Professional | | $60.17 | $174.46 | $255.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.00 / $1,779.00 / $7,456.00
| Facility | | $264.00 | $1,779.00 | $7,456.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.81 / $182.09 / $346.97
| Professional | | $64.81 | $182.09 | $346.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.19 / $65.19 / $65.19
| Facility | | $65.19 | $65.19 | $65.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.97 / $250.76 / $491.65
| Professional | | $86.97 | $250.76 | $491.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.45 / $339.63 / $339.63
| Facility | | $325.45 | $339.63 | $339.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $827.40 / $1,714.23 / $1,975.95
| Professional | | $827.40 | $1,714.23 | $1,975.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.39 / $182.60 / $403.70
| Facility | | $69.39 | $182.60 | $403.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.42 / $250.49 / $398.51
| Professional | | $90.42 | $250.49 | $398.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.37 / $258.87 / $528.39
| Professional | | $78.37 | $258.87 | $528.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.45 / $194.62 / $530.46
| Facility | | $69.45 | $194.62 | $530.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.72 / $261.67 / $502.36
| Professional | | $87.72 | $261.67 | $502.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $949.00 / $2,376.00
| Facility | | $157.00 | $949.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.30 / $303.91 / $492.05
| Professional | | $217.30 | $303.91 | $492.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.35 / $218.06 / $308.66
| Professional | | $194.35 | $218.06 | $308.66 |