- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.79 / $2,747.00 / $4,806.64
| Facility | | $48.79 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.15 / $99.32 / $305.91
| Professional | | $51.15 | $99.32 | $305.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.71 / $355.54 / $2,713.00
| Facility | | $138.71 | $355.54 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.23 / $168.26 / $513.03
| Professional | | $67.23 | $168.26 | $513.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.39 / $94.11 / $184.59
| Facility | | $72.39 | $94.11 | $184.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.37 / $165.40 / $343.49
| Professional | | $92.37 | $165.40 | $343.49 |
- 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
- $70.59 / $157.36 / $368.46
| Professional | | $70.59 | $157.36 | $368.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.08 / $191.61 / $6,679.00
| Facility | | $63.08 | $191.61 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.38 / $191.80 / $265.41
| Professional | | $151.38 | $191.80 | $265.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.00 / $167.86 / $370.11
| Professional | | $77.00 | $167.86 | $370.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.27 / $201.34 / $235.50
| Professional | | $170.27 | $201.34 | $235.50 |
- 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
- $117.87 / $229.84 / $978.56
| Professional | | $117.87 | $229.84 | $978.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.43 / $142.40 / $293.45
| Professional | | $93.43 | $142.40 | $293.45 |
- 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
- $102.95 / $192.88 / $478.45
| Professional | | $102.95 | $192.88 | $478.45 |