- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.66 / $273.00 / $709.05
| Facility | | $158.66 | $273.00 | $709.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.34 / $141.69 / $297.17
| Professional | | $103.34 | $141.69 | $297.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.84 / $502.00 / $2,713.00
| Facility | | $181.84 | $502.00 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.23 / $247.65 / $1,070.40
| Professional | | $121.23 | $247.65 | $1,070.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.00 / $165.77 / $295.93
| Facility | | $129.00 | $165.77 | $295.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.80 / $231.54 / $346.49
| Professional | | $154.80 | $231.54 | $346.49 |
- 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
- $138.22 / $223.13 / $410.57
| Professional | | $138.22 | $223.13 | $410.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.55 / $235.22 / $6,679.00
| Facility | | $110.55 | $235.22 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.21 / $203.76 / $278.54
| Professional | | $168.21 | $203.76 | $278.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.07 / $298.52 / $400.10
| Professional | | $141.07 | $298.52 | $400.10 |
- 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
- $156.93 / $315.39 / $1,070.40
| Professional | | $156.93 | $315.39 | $1,070.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $3,445.00
| Facility | | $627.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.75 / $221.42 / $431.08
| Professional | | $146.75 | $221.42 | $431.08 |