- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.31 / $2,020.00 / $6,691.00
| Facility | | $328.31 | $2,020.00 | $6,691.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.13 / $223.59 / $414.90
| Professional | | $35.13 | $223.59 | $414.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.84 / $35.84 / $240.57
| Professional | | $35.84 | $35.84 | $240.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,845.00 / $4,349.00 / $6,612.00
| Facility | | $1,845.00 | $4,349.00 | $6,612.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.97 / $224.97 / $469.29
| Professional | | $38.97 | $224.97 | $469.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.82 / $41.82 / $41.82
| Facility | | $41.82 | $41.82 | $41.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.69 / $41.82 / $41.82
| Facility | | $35.69 | $41.82 | $41.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.64 / $313.31 / $656.99
| Professional | | $48.64 | $313.31 | $656.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $477.39
| Facility | | $55.00 | $55.00 | $477.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,065.90 / $2,060.00 / $2,421.38
| Professional | | $1,065.90 | $2,060.00 | $2,421.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.11 / $165.73 / $568.97
| Facility | | $40.11 | $165.73 | $568.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.14 / $306.00 / $486.82
| Professional | | $52.14 | $306.00 | $486.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.71 / $370.10 / $528.70
| Professional | | $49.71 | $370.10 | $528.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.14 / $224.71 / $658.86
| Facility | | $40.14 | $224.71 | $658.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.20 / $317.24 / $677.05
| Professional | | $49.20 | $317.24 | $677.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $950.00 / $2,376.00
| Facility | | $157.00 | $950.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.89 / $439.86 / $696.05
| Professional | | $319.89 | $439.86 | $696.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.42 / $264.36 / $377.87
| Professional | | $237.42 | $264.36 | $377.87 |