- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,747.00 / $7,317.00
| Facility | | $540.00 | $2,747.00 | $7,317.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.79 / $126.56 / $244.48
| Professional | | $72.79 | $126.56 | $244.48 |
- 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
- $149.63 / $243.47 / $280.20
| Professional | | $149.63 | $243.47 | $280.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.43 / $141.16 / $234.54
| Professional | | $81.43 | $141.16 | $234.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.12 / $231.58 / $238.90
| Professional | | $180.12 | $231.58 | $238.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,594.33 / $4,502.89 / $8,412.81
| Facility | | $2,594.33 | $4,502.89 | $8,412.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.94 / $147.47 / $151.69
| Professional | | $139.94 | $147.47 | $151.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.22 / $3,077.00 / $8,017.00
| Facility | | $679.22 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.45 / $134.56 / $426.28
| Professional | | $74.45 | $134.56 | $426.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.69 / $162.69 / $185.30
| Professional | | $162.69 | $162.69 | $185.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.97 / $142.97 / $142.97
| Facility | | $142.97 | $142.97 | $142.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.05 / $143.81 / $241.61
| Professional | | $83.05 | $143.81 | $241.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.36 / $81.30 / $148.63
| Facility | | $80.36 | $81.30 | $148.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.36 / $128.33 / $159.24
| Professional | | $80.36 | $128.33 | $159.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $6,000.00
| Facility | | $814.00 | $2,391.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.68 / $165.71 / $293.52
| Professional | | $132.68 | $165.71 | $293.52 |