- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.11 / $1,986.79 / $5,852.39
| Facility | | $225.11 | $1,986.79 | $5,852.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.89 / $183.02 / $477.75
| Professional | | $117.89 | $183.02 | $477.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.93 / $149.07 / $155.49
| Professional | | $86.93 | $149.07 | $155.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.51 / $210.16 / $210.16
| Professional | | $202.51 | $210.16 | $210.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.57 / $201.18 / $361.37
| Professional | | $138.57 | $201.18 | $361.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.52 / $313.08 / $322.92
| Professional | | $243.52 | $313.08 | $322.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.89 / $3,854.41 / $7,483.00
| Facility | | $1,712.89 | $3,854.41 | $7,483.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.12 / $197.47 / $205.37
| Professional | | $185.12 | $197.47 | $205.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.85 / $2,106.00 / $6,762.36
| Facility | | $244.85 | $2,106.00 | $6,762.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.80 / $194.17 / $465.25
| Professional | | $133.80 | $194.17 | $465.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.34 / $218.10 / $293.14
| Professional | | $149.34 | $218.10 | $293.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.74 / $266.74 / $266.74
| Facility | | $266.74 | $266.74 | $266.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.72 / $203.37 / $363.94
| Professional | | $146.72 | $203.37 | $363.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.81 / $151.76 / $198.56
| Facility | | $141.81 | $151.76 | $198.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.06 / $189.53 / $212.52
| Professional | | $148.06 | $189.53 | $212.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.00 / $2,391.00 / $6,000.00
| Facility | | $637.00 | $2,391.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.18 / $221.53 / $397.62
| Professional | | $171.18 | $221.53 | $397.62 |