- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.79 / $2,747.00 / $8,017.00
| Facility | | $180.79 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.91 / $170.58 / $289.64
| Professional | | $94.91 | $170.58 | $289.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.78 / $173.07 / $271.81
| Professional | | $166.78 | $173.07 | $271.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.31 / $165.31 / $165.31
| Facility | | $165.31 | $165.31 | $165.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.82 / $218.81 / $401.16
| Professional | | $106.82 | $218.81 | $401.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.97 / $260.67 / $340.21
| Professional | | $196.97 | $260.67 | $340.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.54 / $358.54 / $358.54
| Facility | | $358.54 | $358.54 | $358.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.33 / $171.39 / $171.67
| Professional | | $90.33 | $171.39 | $171.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.69 / $180.78 / $434.20
| Professional | | $96.69 | $180.78 | $434.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.86 / $294.89 / $516.50
| Professional | | $232.86 | $294.89 | $516.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.31 / $165.31 / $165.31
| Facility | | $165.31 | $165.31 | $165.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.82 / $220.36 / $411.75
| Professional | | $106.82 | $220.36 | $411.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.48 / $165.94 / $304.27
| Facility | | $94.48 | $165.94 | $304.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.48 / $162.76 / $216.65
| Professional | | $94.48 | $162.76 | $216.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.28 / $320.97 / $558.62
| Professional | | $220.28 | $320.97 | $558.62 |