- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.46 / $1,691.00 / $3,363.00
| Facility | | $341.46 | $1,691.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.90 / $108.13 / $298.00
| Professional | | $56.90 | $108.13 | $298.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.62 / $499.32 / $2,713.00
| Facility | | $160.62 | $499.32 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.06 / $197.16 / $671.00
| Professional | | $80.06 | $197.16 | $671.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.42 / $107.15 / $210.17
| Facility | | $82.42 | $107.15 | $210.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.06 / $157.28 / $458.16
| Professional | | $70.06 | $157.28 | $458.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.17 / $188.66 / $401.62
| Professional | | $104.17 | $188.66 | $401.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $300.00 / $6,679.00
| Facility | | $83.43 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.25 / $196.52 / $271.27
| Professional | | $156.25 | $196.52 | $271.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.93 / $197.23 / $386.50
| Professional | | $90.93 | $197.23 | $386.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.13 / $343.36 / $556.52
| Facility | | $226.13 | $343.36 | $556.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.54 / $222.54 / $222.54
| Professional | | $222.54 | $222.54 | $222.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.23 / $279.77 / $1,213.96
| Professional | | $173.23 | $279.77 | $1,213.96 |
- 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
- $142.22 / $213.11 / $386.50
| Professional | | $142.22 | $213.11 | $386.50 |