- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.46 / $585.29 / $2,200.88
| Facility | | $98.46 | $585.29 | $2,200.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.31 / $96.52 / $225.88
| Professional | | $63.31 | $96.52 | $225.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.77 / $347.04 / $2,713.00
| Facility | | $112.77 | $347.04 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.08 / $156.99 / $717.60
| Professional | | $75.08 | $156.99 | $717.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.41 / $104.61 / $186.75
| Facility | | $81.41 | $104.61 | $186.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.13 / $158.82 / $255.97
| Professional | | $103.13 | $158.82 | $255.97 |
- 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
- $84.90 / $140.80 / $266.02
| Professional | | $84.90 | $140.80 | $266.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.43 / $300.00 / $6,679.00
| Facility | | $81.43 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.54 / $140.97 / $194.67
| Professional | | $115.54 | $140.97 | $194.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.03 / $186.35 / $281.50
| Professional | | $89.03 | $186.35 | $281.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.11 / $178.11 / $178.11
| Facility | | $178.11 | $178.11 | $178.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.59 / $152.30 / $306.72
| Professional | | $106.59 | $152.30 | $306.72 |
- 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
- $101.56 / $203.80 / $717.60
| Professional | | $101.56 | $203.80 | $717.60 |
- 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
- $96.72 / $150.46 / $295.32
| Professional | | $96.72 | $150.46 | $295.32 |