- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.74 / $1,319.00 / $3,363.00
| Facility | | $186.74 | $1,319.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.12 / $236.00 / $645.14
| Professional | | $143.12 | $236.00 | $645.14 |
- 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
- $159.87 / $361.58 / $1,061.68
| Professional | | $159.87 | $361.58 | $1,061.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.41 / $224.13 / $411.96
| Facility | | $172.41 | $224.13 | $411.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.96 / $375.11 / $663.19
| Professional | | $233.96 | $375.11 | $663.19 |
- 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
- $182.02 / $370.53 / $759.31
| Professional | | $182.02 | $370.53 | $759.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.61 / $314.38 / $6,679.00
| Facility | | $148.61 | $314.38 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.22 / $370.23 / $512.41
| Professional | | $292.22 | $370.23 | $512.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.22 / $378.16 / $713.12
| Professional | | $180.22 | $378.16 | $713.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.27 / $271.76 / $1,415.37
| Facility | | $181.27 | $271.76 | $1,415.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.80 / $217.14 / $407.99
| Professional | | $206.80 | $217.14 | $407.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,002.72 / $3,445.00
| Facility | | $55.00 | $1,002.72 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.33 / $475.27 / $1,887.12
| Professional | | $240.33 | $475.27 | $1,887.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.67 / $1,509.96 / $2,733.00
| Facility | | $537.67 | $1,509.96 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.57 / $361.62 / $801.65
| Professional | | $190.57 | $361.62 | $801.65 |