- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.05 / $1,473.20 / $3,363.00
| Facility | | $131.05 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.12 / $116.03 / $256.52
| Professional | | $51.12 | $116.03 | $256.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.23 / $679.46 / $2,713.00
| Facility | | $127.23 | $679.46 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.28 / $169.31 / $724.40
| Professional | | $69.28 | $169.31 | $724.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.80 / $81.64 / $156.06
| Facility | | $62.80 | $81.64 | $156.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.57 / $144.09 / $263.22
| Professional | | $93.57 | $144.09 | $263.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.33 / $189.86 / $302.02
| Professional | | $95.33 | $189.86 | $302.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.12 / $168.26 / $6,679.00
| Facility | | $64.12 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.77 / $146.29 / $261.56
| Professional | | $115.77 | $146.29 | $261.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.27 / $149.19 / $274.63
| Professional | | $69.27 | $149.19 | $274.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.72 / $211.93 / $564.69
| Facility | | $66.72 | $211.93 | $564.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.41 / $152.99 / $172.44
| Professional | | $130.41 | $152.99 | $172.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.76 / $274.56 / $724.40
| Professional | | $132.76 | $274.56 | $724.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.70 / $193.78 / $314.26
| Professional | | $123.70 | $193.78 | $314.26 |