- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.07 / $2,747.00 / $7,920.26
| Facility | | $297.07 | $2,747.00 | $7,920.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.97 / $190.47 / $486.76
| Professional | | $127.97 | $190.47 | $486.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.00 / $550.00 / $550.00
| Facility | | $550.00 | $550.00 | $550.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.13 / $288.20 / $424.92
| Professional | | $157.13 | $288.20 | $424.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.86 / $350.04 / $416.26
| Professional | | $296.86 | $350.04 | $416.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.79 / $262.27 / $355.30
| Facility | | $198.79 | $262.27 | $355.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.81 / $264.32 / $414.86
| Professional | | $219.81 | $264.32 | $414.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.18 / $268.00 / $312.89
| Facility | | $185.18 | $268.00 | $312.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.46 / $281.00 / $396.16
| Facility | | $193.46 | $281.00 | $396.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.19 / $302.55 / $417.65
| Professional | | $246.19 | $302.55 | $417.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.70 / $724.26 / $890.90
| Facility | | $564.70 | $724.26 | $890.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.52 / $360.50 / $481.74
| Professional | | $270.52 | $360.50 | $481.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.00 / $3,290.00 / $6,216.00
| Facility | | $376.00 | $3,290.00 | $6,216.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.64 / $284.23 / $471.38
| Professional | | $203.64 | $284.23 | $471.38 |