- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.31 / $142.36 / $1,437.82
| Facility | | $96.31 | $142.36 | $1,437.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.54 / $125.92 / $199.91
| Professional | | $95.54 | $125.92 | $199.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.51 / $512.58 / $2,713.00
| Facility | | $159.51 | $512.58 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.34 / $222.06 / $943.68
| Professional | | $106.34 | $222.06 | $943.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.56 / $145.91 / $260.51
| Facility | | $113.56 | $145.91 | $260.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.97 / $203.83 / $281.86
| Professional | | $147.97 | $203.83 | $281.86 |
- 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
- $125.63 / $201.08 / $362.41
| Professional | | $125.63 | $201.08 | $362.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.11 / $300.00 / $6,679.00
| Facility | | $99.11 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.52 / $179.91 / $246.28
| Professional | | $148.52 | $179.91 | $246.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.85 / $263.02 / $370.41
| Professional | | $123.85 | $263.02 | $370.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.58 / $508.99 / $678.53
| Facility | | $442.58 | $508.99 | $678.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.89 / $213.62 / $228.25
| Professional | | $117.89 | $213.62 | $228.25 |
- 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
- $148.77 / $279.86 / $943.68
| Professional | | $148.77 | $279.86 | $943.68 |
- 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
- $148.36 / $231.36 / $430.37
| Professional | | $148.36 | $231.36 | $430.37 |