- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.26 / $904.43 / $2,747.00
| Facility | | $285.26 | $904.43 | $2,747.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.28 / $285.64 / $776.94
| Professional | | $172.28 | $285.64 | $776.94 |
- 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
- $219.54 / $450.19 / $1,454.64
| Professional | | $219.54 | $450.19 | $1,454.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.12 / $306.95 / $541.66
| Facility | | $236.12 | $306.95 | $541.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.41 / $495.80 / $759.50
| Professional | | $320.41 | $495.80 | $759.50 |
- 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
- $245.88 / $475.35 / $925.81
| Professional | | $245.88 | $475.35 | $925.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.51 / $430.54 / $6,679.00
| Facility | | $203.51 | $430.54 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.41 / $442.31 / $610.55
| Professional | | $349.41 | $442.31 | $610.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.58 / $522.75 / $851.86
| Professional | | $246.58 | $522.75 | $851.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.56 / $349.73 / $712.42
| Facility | | $245.56 | $349.73 | $712.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.58 / $487.54 / $599.60
| Professional | | $310.58 | $487.54 | $599.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,372.98 / $3,445.00
| Facility | | $55.00 | $1,372.98 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.49 / $572.35 / $2,265.84
| Professional | | $294.49 | $572.35 | $2,265.84 |
- 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
- $242.76 / $442.64 / $1,080.84
| Professional | | $242.76 | $442.64 | $1,080.84 |