- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.14 / $2,083.00 / $3,685.00
| Facility | | $190.14 | $2,083.00 | $3,685.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.74 / $190.14 / $468.61
| Professional | | $93.74 | $190.14 | $468.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.61 / $953.00 / $2,733.00
| Facility | | $279.61 | $953.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.38 / $369.99 / $1,895.76
| Professional | | $139.38 | $369.99 | $1,895.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.59 / $191.87 / $376.35
| Facility | | $147.59 | $191.87 | $376.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.03 / $242.03 / $534.54
| Professional | | $242.03 | $242.03 | $534.54 |
- 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
- $190.00 / $422.56 / $789.36
| Professional | | $190.00 | $422.56 | $789.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.24 / $214.32 / $6,679.00
| Facility | | $126.24 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.43 / $388.47 / $586.79
| Professional | | $307.43 | $388.47 | $586.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.18 / $337.50 / $718.55
| Professional | | $156.18 | $337.50 | $718.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.73 / $683.97 / $1,895.76
| Professional | | $251.73 | $683.97 | $1,895.76 |
- 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
- $238.25 / $417.82 / $879.87
| Professional | | $238.25 | $417.82 | $879.87 |