- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.87 / $2,663.12 / $4,665.42
| Facility | | $248.87 | $2,663.12 | $4,665.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.97 / $248.87 / $528.98
| Professional | | $97.97 | $248.87 | $528.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.70 / $2,411.51 / $10,821.00
| Facility | | $318.70 | $2,411.51 | $10,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.55 / $436.03 / $2,133.04
| Professional | | $146.55 | $436.03 | $2,133.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.52 / $200.88 / $394.03
| Facility | | $154.52 | $200.88 | $394.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.40 / $253.40 / $602.32
| Professional | | $253.40 | $253.40 | $602.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.53 / $469.13 / $908.45
| Professional | | $186.53 | $469.13 | $908.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.29 / $214.32 / $6,679.00
| Facility | | $132.29 | $214.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.13 / $437.38 / $755.70
| Professional | | $346.13 | $437.38 | $755.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.72 / $364.95 / $810.23
| Professional | | $163.72 | $364.95 | $810.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.80 / $549.80 / $549.80
| Professional | | $549.80 | $549.80 | $549.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $888.72 / $3,649.00 / $26,542.00
| Facility | | $888.72 | $3,649.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.70 / $784.28 / $2,133.04
| Professional | | $310.70 | $784.28 | $2,133.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.16 / $436.03 / $991.73
| Professional | | $247.16 | $436.03 | $991.73 |