- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.00 / $2,070.00 / $7,799.00
| Facility | | $379.00 | $2,070.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.51 / $234.54 / $326.38
| Professional | | $148.51 | $234.54 | $326.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,772.00 / $2,838.15 / $8,459.92
| Facility | | $1,772.00 | $2,838.15 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.78 / $256.08 / $453.95
| Professional | | $246.78 | $256.08 | $453.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.77 / $273.77 / $273.77
| Facility | | $273.77 | $273.77 | $273.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.78 / $253.13 / $452.86
| Professional | | $161.78 | $253.13 | $452.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.87 / $396.06 / $511.04
| Professional | | $295.87 | $396.06 | $511.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,245.84 / $5,198.18 / $7,262.42
| Facility | | $3,245.84 | $5,198.18 | $7,262.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.66 / $182.53 / $265.14
| Professional | | $153.66 | $182.53 | $265.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,266.00 / $8,017.00
| Facility | | $617.00 | $2,266.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.11 / $240.43 / $848.19
| Professional | | $154.11 | $240.43 | $848.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.20 / $301.20 / $552.90
| Professional | | $301.20 | $301.20 | $552.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.77 / $273.77 / $273.77
| Facility | | $273.77 | $273.77 | $273.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.79 / $257.33 / $456.44
| Professional | | $162.79 | $257.33 | $456.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.53 / $187.16 / $270.99
| Facility | | $156.53 | $187.16 | $270.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.50 / $239.38 / $261.85
| Professional | | $156.50 | $239.38 | $261.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $2,453.00 / $5,214.89
| Facility | | $471.00 | $2,453.00 | $5,214.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.72 / $288.80 / $467.11
| Professional | | $217.72 | $288.80 | $467.11 |