- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.17 / $2,124.00 / $7,316.00
| Facility | | $313.17 | $2,124.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.61 / $224.51 / $355.42
| Professional | | $145.61 | $224.51 | $355.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.06 / $179.99 / $710.65
| Facility | | $105.06 | $179.99 | $710.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.04 / $229.93 / $344.65
| Professional | | $146.04 | $229.93 | $344.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $147.37 / $149.27
| Facility | | $80.00 | $147.37 | $149.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.43 / $269.43 / $269.43
| Facility | | $269.43 | $269.43 | $269.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.11 / $271.10 / $441.28
| Professional | | $172.11 | $271.10 | $441.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $811.63
| Facility | | $55.00 | $55.00 | $811.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,153.04 / $1,864.00 / $2,217.90
| Professional | | $1,153.04 | $1,864.00 | $2,217.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.84 / $246.31 / $371.45
| Facility | | $158.84 | $246.31 | $371.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.36 / $292.39 / $452.68
| Professional | | $204.36 | $292.39 | $452.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.80 / $217.80 / $217.80
| Professional | | $217.80 | $217.80 | $217.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.62 / $247.97 / $377.87
| Facility | | $159.62 | $247.97 | $377.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.25 / $281.04 / $476.44
| Professional | | $173.25 | $281.04 | $476.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $949.00 / $2,405.00
| Facility | | $161.00 | $949.00 | $2,405.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.24 / $259.60 / $397.19
| Professional | | $192.24 | $259.60 | $397.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.44 / $243.11 / $342.72
| Professional | | $216.44 | $243.11 | $342.72 |