- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.94 / $2,202.00 / $7,197.00
| Facility | | $210.94 | $2,202.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.03 / $193.29 / $358.93
| Professional | | $133.03 | $193.29 | $358.93 |
- 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
- $213.24 / $221.29 / $221.29
| Professional | | $213.24 | $221.29 | $221.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $249.95 / $249.95 / $249.95
| Facility | | $249.95 | $249.95 | $249.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.69 / $217.01 / $373.97
| Professional | | $146.69 | $217.01 | $373.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $255.78 / $441.81
| Professional | | $30.00 | $255.78 | $441.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,228.67 / $4,625.39 / $8,875.18
| Facility | | $2,228.67 | $4,625.39 | $8,875.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.18 / $200.52 / $263.81
| Professional | | $141.18 | $200.52 | $263.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $249.24 / $2,467.00 / $8,017.00
| Facility | | $249.24 | $2,467.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.03 / $211.27 / $511.85
| Professional | | $133.03 | $211.27 | $511.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.00 / $276.60 / $459.00
| Professional | | $272.00 | $276.60 | $459.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $249.95 / $249.95 / $249.95
| Facility | | $249.95 | $249.95 | $249.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.10 / $220.92 / $381.86
| Professional | | $149.10 | $220.92 | $381.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.18 / $198.51 / $267.79
| Facility | | $143.18 | $198.51 | $267.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.03 / $206.03 / $225.49
| Professional | | $143.03 | $206.03 | $225.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.00 / $1,219.00 / $3,742.00
| Facility | | $435.00 | $1,219.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.79 / $250.15 / $410.83
| Professional | | $180.79 | $250.15 | $410.83 |