- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.83 / $1,122.02 / $10,000.00
| Facility | | $0.83 | $1,122.02 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $144.54 / $446.68
| Professional | | $70.79 | $144.54 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $229.09 / $501.19
| Professional | | $120.23 | $229.09 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $398.11 / $645.65
| Facility | | $346.74 | $398.11 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $199.53 / $380.19
| Professional | | $95.50 | $199.53 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $229.09 / $3,311.31
| Facility | | $81.28 | $229.09 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $234.42 / $380.19
| Professional | | $154.88 | $234.42 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $229.09 / $3,981.07
| Facility | | $81.28 | $229.09 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $213.80 / $616.60
| Professional | | $117.49 | $213.80 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $234.42
| Professional | | $32.36 | $33.11 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $245.47 / $407.38
| Professional | | $147.91 | $245.47 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $2,238.72 / $2,238.72
| Facility | | $489.78 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $158.49 / $912.01
| Professional | | $83.18 | $158.49 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $354.81 / $549.54
| Professional | | $162.18 | $354.81 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,884.03 / $5,011.87
| Facility | | $2,344.23 | $2,884.03 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $158.49 / $416.87
| Professional | | $85.11 | $158.49 | $416.87 |