- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.64 / $1,625.78 / $3,469.00
| Facility | | $191.64 | $1,625.78 | $3,469.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.85 / $165.35 / $446.74
| Professional | | $100.85 | $165.35 | $446.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.16 / $1,251.81 / $7,161.00
| Facility | | $331.16 | $1,251.81 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.27 / $264.95 / $974.40
| Professional | | $135.27 | $264.95 | $974.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.22 / $209.60 / $369.86
| Facility | | $161.22 | $209.60 | $369.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.63 / $289.39 / $437.12
| Professional | | $203.63 | $289.39 | $437.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.60 / $248.45 / $512.94
| Professional | | $150.60 | $248.45 | $512.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.63 / $220.49 / $6,679.00
| Facility | | $137.63 | $220.49 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.09 / $244.64 / $337.74
| Professional | | $193.09 | $244.64 | $337.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.48 / $344.63 / $530.47
| Professional | | $165.48 | $344.63 | $530.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.86 / $409.37 / $1,559.85
| Facility | | $149.86 | $409.37 | $1,559.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.81 / $204.07 / $422.82
| Professional | | $137.81 | $204.07 | $422.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $922.68 / $2,078.00 / $11,500.00
| Facility | | $922.68 | $2,078.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.15 / $319.47 / $1,251.20
| Professional | | $186.15 | $319.47 | $1,251.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.93 / $239.80 / $479.21
| Professional | | $150.93 | $239.80 | $479.21 |