- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.45 / $1,013.00 / $6,012.00
| Facility | | $268.45 | $1,013.00 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.16 / $238.23 / $353.39
| Professional | | $162.16 | $238.23 | $353.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.07 / $553.74 / $553.74
| Professional | | $292.07 | $553.74 | $553.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.11 / $285.10 / $457.73
| Professional | | $181.11 | $285.10 | $457.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.62 / $454.65 / $469.57
| Professional | | $353.62 | $454.65 | $469.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.46 / $1,712.90 / $3,607.54
| Facility | | $430.46 | $1,712.90 | $3,607.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.61 / $287.61 / $287.61
| Professional | | $287.61 | $287.61 | $287.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.36 / $1,541.00 / $7,175.00
| Facility | | $279.36 | $1,541.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.94 / $268.45 / $597.83
| Professional | | $166.94 | $268.45 | $597.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $227.90 / $305.08
| Professional | | $186.21 | $227.90 | $305.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.04 / $319.04 / $319.04
| Facility | | $319.04 | $319.04 | $319.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.68 / $289.32 / $519.58
| Professional | | $186.68 | $289.32 | $519.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.31 / $183.35 / $291.17
| Facility | | $175.31 | $183.35 | $291.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.13 / $217.66 / $312.74
| Professional | | $178.13 | $217.66 | $312.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $4,300.00
| Facility | | $144.00 | $674.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.61 / $307.45 / $544.62
| Professional | | $236.61 | $307.45 | $544.62 |