- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.39 / $1,418.00 / $3,384.99
| Facility | | $282.39 | $1,418.00 | $3,384.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.35 / $204.57 / $618.92
| Professional | | $132.35 | $204.57 | $618.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.74 / $736.00 / $3,445.00
| Facility | | $246.74 | $736.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.46 / $240.73 / $800.00
| Professional | | $112.46 | $240.73 | $800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.29 / $156.38 / $275.95
| Facility | | $120.29 | $156.38 | $275.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.55 / $247.24 / $402.38
| Professional | | $161.55 | $247.24 | $402.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.36 / $250.03 / $523.94
| Professional | | $148.36 | $250.03 | $523.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.04 / $214.32 / $6,679.00
| Facility | | $104.04 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.31 / $225.23 / $310.89
| Professional | | $178.31 | $225.23 | $310.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.75 / $266.58 / $472.45
| Professional | | $125.75 | $266.58 | $472.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.30 / $487.27 / $4,556.76
| Facility | | $123.30 | $487.27 | $4,556.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.64 / $318.33 / $508.07
| Professional | | $292.64 | $318.33 | $508.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.23 / $1,818.00 / $11,500.00
| Facility | | $516.23 | $1,818.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.41 / $306.98 / $1,162.40
| Professional | | $171.41 | $306.98 | $1,162.40 |
- 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
- $158.56 / $235.03 / $450.66
| Professional | | $158.56 | $235.03 | $450.66 |