- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.17 / $1,145.67 / $3,342.81
| Facility | | $183.17 | $1,145.67 | $3,342.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.84 / $247.59 / $646.48
| Professional | | $127.84 | $247.59 | $646.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $781.24 / $2,713.00
| Facility | | $308.00 | $781.24 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.06 / $364.50 / $1,103.59
| Professional | | $168.06 | $364.50 | $1,103.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.50 / $234.65 / $414.07
| Facility | | $180.50 | $234.65 | $414.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.94 / $400.98 / $661.49
| Professional | | $244.94 | $400.98 | $661.49 |
- 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
- $188.22 / $380.94 / $761.03
| Professional | | $188.22 | $380.94 | $761.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.97 / $329.14 / $6,679.00
| Facility | | $154.97 | $329.14 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.14 / $368.87 / $511.10
| Professional | | $291.14 | $368.87 | $511.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.19 / $396.84 / $709.49
| Professional | | $187.19 | $396.84 | $709.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.61 / $439.97 / $1,962.28
| Facility | | $206.61 | $439.97 | $1,962.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.92 / $437.62 / $650.00
| Professional | | $335.92 | $437.62 | $650.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,042.92 / $3,445.00
| Facility | | $55.00 | $1,042.92 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.28 / $468.55 / $1,878.96
| Professional | | $229.28 | $468.55 | $1,878.96 |
- 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
- $193.59 / $354.14 / $761.24
| Professional | | $193.59 | $354.14 | $761.24 |