- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.37 / $2,618.00 / $3,693.00
| Facility | | $129.37 | $2,618.00 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.37 / $245.54 / $547.73
| Professional | | $129.37 | $245.54 | $547.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.62 / $559.45 / $2,713.00
| Facility | | $240.62 | $559.45 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.21 / $449.34 / $2,395.84
| Professional | | $161.21 | $449.34 | $2,395.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.29 / $220.11 / $436.79
| Facility | | $171.29 | $220.11 | $436.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.22 / $458.58 / $827.60
| Professional | | $224.22 | $458.58 | $827.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.68 / $382.79 / $864.82
| Professional | | $180.68 | $382.79 | $864.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.12 / $234.24 / $6,679.00
| Facility | | $146.12 | $234.24 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.05 / $475.87 / $665.32
| Professional | | $390.05 | $475.87 | $665.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.19 / $411.24 / $910.90
| Professional | | $194.19 | $411.24 | $910.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.67 / $364.42 / $3,863.50
| Facility | | $203.67 | $364.42 | $3,863.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.83 / $218.11 / $430.23
| Professional | | $184.83 | $218.11 | $430.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.64 / $650.12 / $2,395.84
| Professional | | $326.64 | $650.12 | $2,395.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.08 / $482.96 / $989.03
| Professional | | $311.08 | $482.96 | $989.03 |