- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.00 / $5,576.00 / $17,030.00
| Facility | | $462.00 | $5,576.00 | $17,030.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.20 / $216.18 / $768.30
| Professional | | $114.20 | $216.18 | $768.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $4,718.00 / $9,381.00
| Facility | | $1,787.00 | $4,718.00 | $9,381.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.19 / $269.66 / $571.66
| Professional | | $155.19 | $269.66 | $571.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $6,881.37
| Facility | | $66.00 | $100.00 | $6,881.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.84 / $239.24 / $472.50
| Professional | | $125.84 | $239.24 | $472.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.71 / $1,182.65 / $2,786.23
| Facility | | $1,000.71 | $1,182.65 | $2,786.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.91 / $243.72 / $708.85
| Professional | | $127.91 | $243.72 | $708.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.63 / $338.60 / $457.11
| Professional | | $136.63 | $338.60 | $457.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.98 / $276.54 / $502.35
| Professional | | $122.98 | $276.54 | $502.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $957.04 / $977.27 / $16,394.00
| Facility | | $957.04 | $977.27 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,379.00 / $1,917.60 / $2,252.78
| Professional | | $1,379.00 | $1,917.60 | $2,252.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.43 / $228.80 / $437.65
| Facility | | $138.43 | $228.80 | $437.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.60 / $260.54 / $692.00
| Professional | | $129.60 | $260.54 | $692.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.40 / $382.40 / $893.31
| Professional | | $382.40 | $382.40 | $893.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.61 / $151.68 / $376.34
| Professional | | $122.61 | $151.68 | $376.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,230.00 / $4,060.00 / $9,131.00
| Facility | | $2,230.00 | $4,060.00 | $9,131.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.75 / $287.39 / $916.76
| Professional | | $190.75 | $287.39 | $916.76 |