- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.05 / $1,462.97 / $3,363.00
| Facility | | $327.05 | $1,462.97 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.00 / $249.89 / $542.36
| Professional | | $171.00 | $249.89 | $542.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $1,878.00 / $7,161.00
| Facility | | $540.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.07 / $435.57 / $1,654.00
| Professional | | $217.07 | $435.57 | $1,654.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.91 / $350.88 / $619.16
| Facility | | $269.91 | $350.88 | $619.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.26 / $494.85 / $742.48
| Professional | | $341.26 | $494.85 | $742.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.69 / $419.78 / $853.04
| Professional | | $254.69 | $419.78 | $853.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.37 / $492.14 / $6,679.00
| Facility | | $232.37 | $492.14 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.43 / $396.68 / $547.57
| Professional | | $315.43 | $396.68 | $547.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.20 / $584.11 / $874.28
| Professional | | $282.20 | $584.11 | $874.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $579.36 / $579.36 / $579.36
| Facility | | $579.36 | $579.36 | $579.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.75 / $223.75 / $342.29
| Professional | | $223.75 | $223.75 | $342.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,078.00 / $12,000.00
| Facility | | $1,106.00 | $2,078.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.27 / $529.48 / $2,054.80
| Professional | | $305.27 | $529.48 | $2,054.80 |
- 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
- $261.42 / $398.93 / $846.36
| Professional | | $261.42 | $398.93 | $846.36 |