- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.64 / $2,836.00 / $7,235.00
| Facility | | $124.64 | $2,836.00 | $7,235.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.99 / $130.72 / $291.35
| Professional | | $63.99 | $130.72 | $291.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,691.00 / $3,382.00 / $4,707.00
| Facility | | $1,691.00 | $3,382.00 | $4,707.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.19 / $132.85 / $314.20
| Professional | | $86.19 | $132.85 | $314.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.16 / $130.16 / $4,050.00
| Facility | | $130.16 | $130.16 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.16 / $130.16 / $239.98
| Professional | | $130.16 | $130.16 | $239.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.34 / $156.34 / $14,648.00
| Facility | | $156.34 | $156.34 | $14,648.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.20 / $171.50 / $387.45
| Professional | | $75.20 | $171.50 | $387.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.00 / $114.24 / $332.00
| Facility | | $35.00 | $114.24 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.72 / $222.99 / $466.14
| Professional | | $188.72 | $222.99 | $466.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.22 / $152.94 / $307.45
| Professional | | $101.22 | $152.94 | $307.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.07 / $671.07 / $777.32
| Facility | | $671.07 | $671.07 | $777.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.34 / $555.00 / $74,999.25
| Facility | | $156.34 | $555.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.09 / $198.42 / $424.02
| Professional | | $87.09 | $198.42 | $424.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $964.00 / $2,826.00 / $4,851.00
| Facility | | $964.00 | $2,826.00 | $4,851.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.96 / $186.05 / $409.58
| Professional | | $105.96 | $186.05 | $409.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.70 / $100.70 / $207.46
| Facility | | $100.70 | $100.70 | $207.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.22 / $164.41 / $351.26
| Professional | | $101.22 | $164.41 | $351.26 |