- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.00 / $1,700.27 / $3,363.00
| Facility | | $537.00 | $1,700.27 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.59 / $145.75 / $420.00
| Professional | | $78.59 | $145.75 | $420.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.68 / $1,345.23 / $3,804.00
| Facility | | $186.68 | $1,345.23 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.24 / $204.96 / $595.44
| Professional | | $89.24 | $204.96 | $595.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.46 / $127.07 / $219.17
| Facility | | $99.46 | $127.07 | $219.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.52 / $224.00 / $503.61
| Professional | | $132.52 | $224.00 | $503.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $174.22 / $6,679.00
| Facility | | $83.43 | $174.22 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.87 / $183.27 / $327.67
| Professional | | $151.87 | $183.27 | $327.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.63 / $228.71 / $390.73
| Professional | | $103.63 | $228.71 | $390.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.78 / $1,494.48 / $2,151.10
| Facility | | $521.78 | $1,494.48 | $2,151.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.02 / $67.09 / $165.53
| Professional | | $66.02 | $67.09 | $165.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,878.00 / $7,161.00
| Facility | | $55.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.05 / $292.56 / $905.60
| Professional | | $172.05 | $292.56 | $905.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.71 / $217.98 / $398.16
| Professional | | $152.71 | $217.98 | $398.16 |