- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.55 / $988.00 / $3,103.52
| Facility | | $154.55 | $988.00 | $3,103.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.25 / $111.06 / $245.00
| Professional | | $36.25 | $111.06 | $245.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.80 / $502.00 / $2,733.00
| Facility | | $92.80 | $502.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.52 / $128.47 / $355.82
| Professional | | $40.52 | $128.47 | $355.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.06 / $57.58 / $110.61
| Facility | | $45.06 | $57.58 | $110.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.14 / $121.43 / $252.17
| Professional | | $58.14 | $121.43 | $252.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.54 / $112.73 / $262.08
| Professional | | $42.54 | $112.73 | $262.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.38 / $168.26 / $6,679.00
| Facility | | $44.38 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.64 / $140.18 / $194.85
| Professional | | $110.64 | $140.18 | $194.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.88 / $121.24 / $273.88
| Professional | | $45.88 | $121.24 | $273.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.28 / $339.64 / $512.25
| Facility | | $247.28 | $339.64 | $512.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.38 / $145.07 / $330.62
| Professional | | $93.38 | $145.07 | $330.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.73 / $164.47 / $712.72
| Professional | | $110.73 | $164.47 | $712.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.81 / $243.05 / $497.06
| Facility | | $30.81 | $243.05 | $497.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.57 / $53.76 / $157.62
| Professional | | $17.57 | $53.76 | $157.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $3,445.00
| Facility | | $627.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.77 / $146.63 / $278.93
| Professional | | $97.77 | $146.63 | $278.93 |