- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.00 / $2,107.00 / $7,367.52
| Facility | | $466.00 | $2,107.00 | $7,367.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.10 / $393.38 / $596.82
| Professional | | $307.10 | $393.38 | $596.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.74 / $342.74 / $342.74
| Professional | | $342.74 | $342.74 | $342.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.12 / $381.73 / $1,462.80
| Facility | | $215.12 | $381.73 | $1,462.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.81 / $420.57 / $615.02
| Professional | | $327.81 | $420.57 | $615.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.89 / $301.89 / $429.32
| Facility | | $301.89 | $301.89 | $429.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.87 / $492.15 / $764.56
| Professional | | $364.87 | $492.15 | $764.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $1,854.07
| Facility | | $55.00 | $55.00 | $1,854.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,646.88 / $3,657.75 / $3,784.20
| Professional | | $2,646.88 | $3,657.75 | $3,784.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.75 / $465.87 / $777.28
| Facility | | $337.75 | $465.87 | $777.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.94 / $601.58 / $816.43
| Professional | | $438.94 | $601.58 | $816.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.39 / $427.51 / $538.08
| Professional | | $315.39 | $427.51 | $538.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.75 / $465.87 / $815.96
| Facility | | $337.75 | $465.87 | $815.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.78 / $516.26 / $838.05
| Professional | | $381.78 | $516.26 | $838.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $960.00 / $2,376.00
| Facility | | $161.00 | $960.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.57 / $459.42 / $749.34
| Professional | | $344.57 | $459.42 | $749.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.62 / $423.13 / $592.38
| Professional | | $374.62 | $423.13 | $592.38 |