- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.93 / $1,803.00 / $3,363.00
| Facility | | $265.93 | $1,803.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.76 / $276.67 / $574.01
| Professional | | $163.76 | $276.67 | $574.01 |
- 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
- $236.21 / $513.80 / $1,568.32
| Professional | | $236.21 | $513.80 | $1,568.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.00 / $330.20 / $582.67
| Facility | | $254.00 | $330.20 | $582.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.12 / $553.59 / $910.24
| Professional | | $341.12 | $553.59 | $910.24 |
- 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
- $269.52 / $508.33 / $1,085.70
| Professional | | $269.52 | $508.33 | $1,085.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.18 / $463.14 / $6,679.00
| Facility | | $219.18 | $463.14 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.03 / $509.36 / $703.31
| Professional | | $402.03 | $509.36 | $703.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.83 / $562.76 / $979.03
| Professional | | $265.83 | $562.76 | $979.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.16 / $219.87 / $232.68
| Facility | | $164.16 | $219.87 | $232.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.87 / $306.87 / $322.20
| Professional | | $306.87 | $306.87 | $322.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,479.84 / $3,445.00
| Facility | | $55.00 | $1,479.84 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.10 / $664.19 / $2,603.76
| Professional | | $326.10 | $664.19 | $2,603.76 |
- 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
- $287.64 / $499.21 / $996.29
| Professional | | $287.64 | $499.21 | $996.29 |