- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.00 / $2,131.00 / $7,513.00
| Facility | | $487.00 | $2,131.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.48 / $388.00 / $562.95
| Professional | | $333.48 | $388.00 | $562.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.36 / $616.98 / $1,385.30
| Facility | | $345.36 | $616.98 | $1,385.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.64 / $340.08 / $622.22
| Professional | | $267.64 | $340.08 | $622.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.08 / $293.08 / $314.75
| Facility | | $293.08 | $293.08 | $314.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.68 / $1,322.00 / $1,487.00
| Facility | | $392.68 | $1,322.00 | $1,487.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.36 / $476.15 / $747.83
| Professional | | $347.36 | $476.15 | $747.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $2,698.22
| Facility | | $55.00 | $55.00 | $2,698.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,411.19 / $3,411.19 / $3,411.19
| Professional | | $3,411.19 | $3,411.19 | $3,411.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.00 / $435.73 / $751.79
| Facility | | $338.00 | $435.73 | $751.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.99 / $479.81 / $595.62
| Professional | | $363.99 | $479.81 | $595.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.62 / $468.10 / $769.90
| Professional | | $291.62 | $468.10 | $769.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.42 / $443.12 / $852.50
| Facility | | $338.42 | $443.12 | $852.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.70 / $514.63 / $872.04
| Professional | | $357.70 | $514.63 | $872.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $949.00 / $2,308.00
| Facility | | $157.00 | $949.00 | $2,308.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.83 / $382.73 / $605.63
| Professional | | $285.83 | $382.73 | $605.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.41 / $329.56 / $444.69
| Professional | | $282.41 | $329.56 | $444.69 |