- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.36 / $1,178.46 / $6,012.00
| Facility | | $514.36 | $1,178.46 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.64 / $122.84 / $200.32
| Professional | | $44.64 | $122.84 | $200.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.65 / $130.11 / $234.74
| Professional | | $98.65 | $130.11 | $234.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $147.97 / $195.16 / $352.13
| Professional | 50 | $147.97 | $195.16 | $352.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.48 / $116.07 / $226.71
| Professional | | $45.48 | $116.07 | $226.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.40 / $182.40 / $185.34
| Professional | | $182.40 | $182.40 | $185.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.56 / $743.34 / $1,012.79
| Facility | | $265.56 | $743.34 | $1,012.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.65 / $95.30 / $154.97
| Professional | | $78.65 | $95.30 | $154.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.00 / $1,633.00 / $7,175.00
| Facility | | $594.00 | $1,633.00 | $7,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.44 / $128.77 / $293.75
| Professional | | $44.44 | $128.77 | $293.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.32 / $113.13 / $252.14
| Professional | | $35.32 | $113.13 | $252.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.52 / $126.61 / $226.71
| Professional | | $46.52 | $126.61 | $226.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.59 / $95.65 / $147.19
| Facility | | $37.59 | $95.65 | $147.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.59 / $95.65 / $119.98
| Professional | | $37.59 | $95.65 | $119.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $650.00 / $3,742.00
| Facility | | $144.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.69 / $149.30 / $233.01
| Professional | | $100.69 | $149.30 | $233.01 |